Hepatitis A acute liver failure: follow‐up of paediatric patients in southern Brazil

Ferreira, Cristina Targa; Vieira, S; Kieling, Carlos Oscar; Silveira, Themis Reverbel da

doi:10.1111/j.1365-2893.2008.01033.x

Cited by 24 publications

(15 citation statements)

References 21 publications

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“…HAV infection was estimated to be the cause of FHF in 58% of cases in children in another study in Argentina, which retrospectively reviewed cases from 1992 to 2003 4. A retrospective analysis in Brazil has reported that 39% of FHF cases in children recorded during a 10-year period were associated with HAV infection 13. Between 1994 and 2009, acute HAV infection was the cause of 18% of pediatric FHF cases included in a prospective study in Chile 14.…”

Section: Discussionmentioning

confidence: 99%

Decline in HAV-associated fulminant hepatic failure and liver transplant in children in Argentina after the introduction of a universal hepatitis A vaccination program

Cervio¹,

Trentadue²,

D’Agostino³

et al. 2011

HMER

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IntroductionHepatitis A virus (HAV) infection is a vaccine-preventable disease. The most severe complication in children is fulminant hepatic failure (FHF), estimated to occur in 0.4% of cases; patients with FHF often require a liver transplant (LT). Following another outbreak of HAV infection in Argentina during 2003–2004, a one-dose HAV universal immunization (UI) program was started in 2005, resulting in a reduction in the incidence of HAV infection. We have investigated the impact of HAV UI on the trends in the occurrence of FHF and LT in children.MethodsAll pediatric cases of FHF admitted to four pediatric centers in Buenos Aires during March 1993–July 2005 were retrospectively reviewed, and data of cases during August 2005–December 2008 were collected. Information about demography, HAV infections and vaccination status, diagnostic data for FHF using the Pediatric Acute Liver Failure criteria, clinical laboratory results, encephalopathy, the severity of liver disease using the Pediatric End Stage Liver Disease score, assessment of patients on the LT waiting list using King’s College Criteria for LT, treatment given for FHF (pre- and post-transplant), and clinical outcome were collected using a case report form. The frequency and outcomes of HAV-associated FHF and LT cases before and after UI were analyzed.ResultsDuring the pre-immunization period, March 1993–July 2005, 54.6% (N = 165) of FHF cases were caused by HAV; HAV-associated FHF cases peaked during 2003–2004. During the post-immunization period, August 2005–December 2008, only 27.7% (N = 18) of FHF cases were caused by HAV infection; only one of these patients had received the HAV vaccine (one dose only). The number of HAV-associated FHF cases decreased from 2005, and no cases were reported from November 2006–December 2008. Multivariate analyses showed that the association of FHF with HAV infection rather than other etiologies decreased with increasing age (P = 0.03), UI against HAV (P = 0.002), and anti-actin antibodies (P = 0.002), and increased with increasing weight (P = 0.0004).ConclusionsThe number of children with HAV-associated FHF in Argentina has strongly decreased since the initiation of the UI program. Further monitoring is required to confirm the long-term health and economic benefits of UI against HAV infection.

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Section: Discussionmentioning

confidence: 99%

Decline in HAV-associated fulminant hepatic failure and liver transplant in children in Argentina after the introduction of a universal hepatitis A vaccination program

Cervio¹,

Trentadue²,

D’Agostino³

et al. 2011

HMER

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show abstract

“…Embora as crianças apresentem, em geral, a forma mais benigna da doença, podem ocorrer também quadros graves 20 . Em estudo recente no Hospital de Clínicas de Porto Alegre, das 33 crianças e adolescentes com insuficiência hepática aguda, a hepatite pelo vírus A foi responsável por 39% (13/33) dos casos e por 69% (9/13) dos óbitos 21 . Em Minas Gerais, Mesquita et al 22 mostraram que dos 10 casos de pacientes com hepatite fulminante transplantados apenas 5 tiveram a causa determinada, sendo que em dois deles foi relacionada ao vírus A 22 .…”

Section: Discussionunclassified

Shifting susceptibility to hepatitis A among children and adolescents over the past decade

Krebs¹,

Ranieri²,

Kieling³

et al. 2011

J Pediatr (Rio J)

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“…Children infected with HAV tend to have mild or no clinical disease while older HAV‐infected persons tend to have more severe disease and an increased HAV‐associated mortality infection can cause fulminant hepatitis in developing countries [1].…”

Section: Hepatitis a Virus Infectionmentioning

confidence: 99%

Has the time come to control hepatitis A globally? Matching prevention to the changing epidemiology

Hendrickx

Herck

Vorsters

et al. 2008

Journal of Viral Hepatitis

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For the first time a global meeting on hepatitis A virus (HAV) infection as vaccine preventable disease was organized at the end of 2007. More than 200 experts from 46 countries gathered to investigate the changing global HAV epidemiology reflecting the increasing numbers of persons at risk for severe clinical disease and mortality from HAV infection. The benefits of childhood and adult hepatitis A (HepA) vaccination strategies and the data needed by individual countries and international health organizations to assess current HepA prevention strategies were discussed. New approaches in preventing HAV infection including universal HepA vaccination were considered. This introductory paper summarizes the major findings of the meeting and describes the changing epidemiology of HAV infections and the impact of HepA vaccination strategies in various countries. Implementation of HepA vaccination strategies should take into account the level of endemicity, the level of the socio-economic development and sanitation, and the risk of outbreaks. A stepwise strategy for introduction of HepA universal immunisation of children was recommended. This strategy should be based on accurate surveillance of cases and qualitative documentation of outbreaks and their control, secure political support on the basis of high-quality results, and comprehensive cost-effectiveness studies. The recognition of the need for increased global attention towards HepA prevention is an important outcome of this meeting.

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Hepatitis A acute liver failure: follow‐up of paediatric patients in southern Brazil

Cited by 24 publications

References 21 publications

Decline in HAV-associated fulminant hepatic failure and liver transplant in children in Argentina after the introduction of a universal hepatitis A vaccination program

Decline in HAV-associated fulminant hepatic failure and liver transplant in children in Argentina after the introduction of a universal hepatitis A vaccination program

Shifting susceptibility to hepatitis A among children and adolescents over the past decade

Has the time come to control hepatitis A globally? Matching prevention to the changing epidemiology

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