Hepatitis E: Epidemiology, Clinical Course: Paediatric Population North India

Objective: Hepatitis E virus is a hepatotropic virus,endemic in the developing world. It causes outbreaks and sporadic cases due to fecal contamination of water supplies, genotype 1 and 2 being responsible. Symptomatic disease in endemic hotspots is commonly seen in young adults (15-40 years). Asymptomatic/mild infection is common in children and in majority cases, disease goes unnoticed. With this background in mind, this study was designed to estimate the prevalence of HEV in a dedicated children’s hospital and to describe the clinical profile of HEV positive patients. MATERIAL AND METHODS: The prevalence of HEV in children was analysed between 2015 and 2020. Clinical and laboratory parameters of all patients who were admitted between this time frame were scrutinised. RESULTS: A total of 19,147 samples were received for IgM HEV in 6 years. Fifty four HEV positive children required hospitalisation between 2015 and 2020. Thirty one of these were males(57%). Maximum admissions were seen in those aged more than 5 years of age(81%). Fever was the most common presenting complaint. Acute hepatitis was seen in 28 patients and fulminant hepatitis in 6 patients. Hepatitis A virus was the most common co-infection seen in these patients(20%) followed by enteric fever(9%).Immune deficiency was an underlying factor in 5 patients. Majority of the patients recovered from the illness(>90%). CONCLUSIONS: HEV is more common in children aged above 5 years of age. It causes asymptomatic/mild illness in majority of the cases. Associated infection with other hepatotropic viruses like HAV may be seen in some cases. Progression to chronic liver disease may be seen in immune deficient children, hence follow up is necessary and vaccination should be introduced in this group of patients.