OUTBREAK OF VIRAL HEPATITIS A IN VINNITSYA REGION IN WARTIME PERIOD AMONG PEDIATRIC POPULATION: CLINICAL AND LABORATORY FEATURES

Introduction. HAV is a ubiquitous viral disease with a faecal-oral transmission mechanism, characterized by liver lesions. According to global data reposts, the frequency of HAV outbreaks all over the world had increased. From the beginning of the outbreak of HAV (Vinnytsia, Ukraine) in 2023 incidence rate of HAV was detected as 27,25 per 100,000 (in 2022—0,35 per 100,000). Having analyzed these data, outbreak of HAV also were registered among the pediatric population (88 out of 454 cases during outbreak; 19,3%). Incidence and evidence rates of HAV had increased, especially in regions with increased rates of military activities, also, these facts had shown the increasing role of HAV on the burden of the public health system. Aim. To estimate the peculiarities of clinical, laboratory features, genotype distribution of HAV among pediatric patients of Vinnitsya region during outbreak in 2023–2024 years. Materials and methods. Among 88 pediatric patients with HAV during the outbreak, 31 children were examined in the course of the study and formed the study group (boys—51,6%; average age—12,84±0,16 years). Clinical examination of all patients, laboratory and instrumental assays, ELISA, PCR-testing were performed in accordance with the standard of management. All cases of HAV (n=31; 100%) were confirmed by ELISA and additionally PCR-testing was performed for 16,1% (n=5) of examined. Statistical data analysis was performed using «SPSS v.22.0». The data were considered significant at p<0.05. Results. During the outbreak, out of all 454 cases of HAV, 46 serum samples were tested by PCR with genome sequencing and in 78,2% (n=36) was detected IB genotype of HAV, while in 21,8% (n=10) – IA genotype. Among pediatric patients (n=5), IB genotype was detected in serum of 80% (n=4) of tested, while IA—in 20% (n=1). Clinical course of HAV had a severe course in 100% (n=31) of study group according to laboratory indexes. Frequency of clinical symptoms was detected in the study group. The level of total bilirubin, ALT, AST among study group in the serum was estimated with clinical significance. Severe laboratory course of HAV among the study group could be explained by spreading of IB genotype of HAV during outbreak. Conclusions. The outbreak of HAV with a severe clinical course in the Vinnitsya region in 2023–2024 in the population was associated with IB genotype of HAV. Among the examined paediatric patients IB genotype of HAV was detected in 80%. The clinical course of HAV in 100% (n=31) of the main group was severe according to laboratory parameters.