Incidence and natural history of chemically defined varicella-zoster virus hepatitis in children and adolescents.
Of 786 children and adolescents enrolled in a multicenter trial of acyclovir for chickenpox, 27 (3.4%) met the case definition of varicella-zoster virus (VZV) hepatitis (serum aspartate aminotransferase level > or = 100 U/l). The clinical and cutaneous manifestations of chickenpox in the 15 placebo recipients with this complication did not differ significantly from those in 45 matched controls (p > 0.05), indicating that liver involvement by VZV is not a consequence of more extensive disease. Although acyclovir modified the course of chickenpox overall, it did not prevent VZV hepatitis; that is, the proportions of affected subjects with liver involvement postenrollment did not differ significantly between the drug and placebo recipients (50% vs 80%, p > 0.05). Serum aspartate aminotransferase levels that were elevated on day 4 postenrollment had returned to normal (< or = 60 U/l) by day 28 in 88% of the placebo group and in 83% of the drug-treated group. With 2 exceptions, all values were normal by 88 days postenrollment. We conclude that chemically defined VZV hepatitis is an infrequent, self-limiting complication of chickenpox in otherwise healthy children and adolescents.
Feldman
S
S
Department of Pediatrics, University of Mississippi Medical Center, Jackson, USA.
Crout
J D
JD
Andrew
M E
ME
D000212:Acyclovir / Q000627:therapeutic use; D000293:Adolescent; D000998:Antiviral Agents / Q000627:therapeutic use; D001219:Aspartate Aminotransferases / Q000097:blood; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D002644:Chickenpox / Q000150:complications* / Q000188:drug therapy; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D006525:Hepatitis, Viral, Human / Q000150:complications* / Q000453:epidemiology; D014645:Herpesvirus 3, Human; D006801:Humans; D015994:Incidence; D008922:Mississippi / Q000453:epidemiology; D018709:Statistics, Nonparametric
D000998:Antiviral Agents; D001219:Aspartate Aminotransferases; D000212:Acyclovir