Clinico-etiological profile and predictors of outcome in pediatric acute hepatitis: an observational study from South India

Acute hepatitis (AH) is a common cause of pediatric hospitalization, with infectious and non-infectious etiologies. This study aims to assess the clinical profile, etiologies, and predictors of adverse outcomes in hospitalized children with AH. Medical case records of children aged >6 months to 14 years from June 2022 to December 2024, identified from pediatric admission and discharge registers, were screened. Children satisfying the criteria for elevated transaminases were included in this study. Those with chronic liver disease/chronic hepatitis were excluded. A total of 165 children were included, with the majority belonging to the 5-14 years age group (70.3%) and being male (53.9%). The median age of the children enrolled was 8 (5-10) years. Infectious etiologies accounted for 83.03% of cases, with dengue (23%), HAV (21.2%), and enteric fever (13.3%) being the most common causes. Non-infectious causes accounted for 9.09% of cases, while 7.88% were idiopathic. Multivariate analysis identified younger age (adjusted OR: 0.79, 95% CI: 0.67-0.91; P-value .002), fever (adjusted OR: 9.13, 95% CI: 2.1-55.9; P-value .007), lethargy at presentation (adjusted OR: 3.1, 95% CI: 1.0-9.61, P-value .047), ascites (adjusted OR: 8.12, 95% CI: 2.44-30, P-value <.001), and hypoalbuminemia (adjusted OR: 0.3, 95% CI: 0.11-0.76, P-value <.014) as significant risk factors for adverse outcomes. Younger age, fever, lethargy, ascites, and hypoalbuminemia were identified as independent risk factors for adverse outcomes. Early recognition of these predictors and targeted management strategies may improve clinical outcomes in hospitalized children with AH.