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The etiology of acute hepatitis in hospitalized children in Cairo, Egypt

Ätiologie der akuten Hepatitis bei hospitalisierten Kindern in Kairo, Ägypten

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Summary

Seromarkers for hepatitis A, B and D were used to determine the cause of acute hepatitis in 94 children (age 2 to 14 years) propsectively studied when they were admitted to Embaba Fever Hospital in Cairo, Egypt, between January and April 1983. The diagnoses were: hepatitis A (4%), hepatitis B (33%), acute hepatitis in HBsAg carriers (10%), dual infections with A and B (2%), and hepatitis non-A, non-B (NANB) (50%). Past hepatitis A was diagnosed in 96%. Among acute hepatitis B infections, 17% (5 of 29 tested) had anti-delta antibody; of HBsAg positive persons, 15% (6 of 40) were HBeAg positive. Two patients had simultaneous presence of HBsAg and anti-HBs. For differential diagnosis, clinical, epidemiological, and biochemical findings were evaluated but did not distinguish hepatitis B from NANB hepatitis. Males predominated for HBV infections. No risk factors were found for 58% of HBV and 70% of NANB infections; of the remaining patients, 42% percent of HBV and 30% of NANB infections were associated with injections or surgery but none with transfusion or known contact with hepatitis cases.

Zusammenfassung

Bei 94 Kindern mit akuter Hepatitis im Alter von zwei bis 14 Jahren wurde bei Einweisung in das Embaba Fever Hospital in Kairo, Ägypten, im Zeitraum von Januar bis April 1983 eine ätiologische Abklärung mittels Seromarkern für Hepatitis A, B und D vorgenommen. Bei 4% der Kinder wurde eine Hepatitis A, bei 33% eine Hepatitis B, bei 10% eine akute Hepatitis bei HBsAg-Trägerstatus, bei 2% eine Doppelinfektion mit HAV und HBV und bei 50% eine Non-A, Non-B-Hepatitis diagnostiziert. 96% der Kinder hatten eine Hepatitis A durchgemacht. 17% (fünf der 29 getesteten) Kinder mit akuter Hepatitis B wiesen Anti-delta-Antikörper auf. 15% (sechs von 40) HBsAg-positive Kinder waren HBeAg positiv. Bei zwei Patienten fanden sich gleichzeitig HBsAg und anti-HBs. Klinische, epidemiologische und biochemische Befunde wurden differential-diagnostisch ausgewertet, sie trugen jedoch nicht zu einer Differenzierung zwischen Hepatitis B und NANB bei. Bei HBV-Infektionen waren Buben häufiger betroffen. 58% der Kinder mit HBV- und 70% der Kinder mit NANB-Virus-Infektionen wiesen keine Risikofaktoren auf. 42% der übrigen mit HBV und 30% der mit NANB-Viren infizierten Kinder hatten Injektionen oder einen chirurgischen Eingriff erhalten, in keinem Fall war eine Bluttransfusion erfolgt oder Kontakt mit einem Hepatitisfall bekannt.

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Authors and Affiliations

  1. Department of Endemic Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt

    S. Zakaria M.D., M. S. Zakaria M.D. (Assistant Professors of Tropical Medicine) & E. H. El-Raziky (Professor of Tropical Medicine)

  2. Department of Epidemiology and International Health, School of Medicine, University of California, 94143, San Francisco, CA, U.S.A.

    R. S. Goldsmith M.D., M.P.H. (Professor of Tropical Medicine and Epidemiology)

  3. Department of Clinical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt

    M. A. Kamel M.D. (Professor of Clinical Pathology)

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  1. S. Zakaria M.D.
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  2. M. S. Zakaria M.D.
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  3. E. H. El-Raziky
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  4. R. S. Goldsmith M.D., M.P.H.
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  5. M. A. Kamel M.D.
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Zakaria, S., Zakaria, M.S., El-Raziky, E.H. et al. The etiology of acute hepatitis in hospitalized children in Cairo, Egypt. Infection 16, 277–282 (1988). https://doi.org/10.1007/BF01645072

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