Hepatitis E virus coinfection with hepatotropic viruses in Egyptian children.
OBJECTIVE
Major hepatotropic viruses continue to be important causes of acute viral hepatitis in developing countries. This work was carried out to detect the seroprevalence of hepatitis E virus (HEV) markers in children with acute viral hepatitis due to hepatotropic viruses (A, B and C) and non-A, non-B, non-C acute hepatitis, and to ascertain the influence of HEV superinfection in individuals infected with hepatitis viruses (A, B and C).


METHODS
We studied prospectively 162 children with sporadic acute hepatitis who reported to our hospital. Thirteen healthy controls were also included in the study. Laboratory investigations were performed, including complete liver function tests. Complete serological profiles for hepatitis viruses A, B, C and E were evaluated.


RESULTS
HEV immunoglobulin G was detected with highest percentage among patients with hepatitis B (56.7%), followed by patients with hepatitis C virus (52.0%), hepatitis A virus (34.1%) and combined hepatitis B and C viruses (30.0%). The detection rate among patients with non-A, non-B, non-C hepatitis was 7.1%. HEV immunoglobulin M was found in 4.5% of hepatitis A virus patients and in 3.3% of hepatitis B patients. The prevalence of HEV immunoglobulin G and immunoglobulin M correlated with the levels of hepatic aspartate aminotransferase and alanine aminotransferase in patients with dual markers of infection with hepatitis E and other viruses compared to patients with acute hepatitis due to A and C viruses.


CONCLUSIONS
HEV serological markers are common among children with acute viral hepatitis, especially from hepatitis C and B viruses. There may be increased sensitivity to HEV coinfection in association with hepatitis B and C infections. Dual infection with HEV and other hepatotropic viruses was associated with greater elevation of aspartate and alanine aminotransferases.
Zaki
Maysaa El Sayed
Mel S
Department of Clinical Pathology, Faculty of Medicine, Mansoura University, Egypt. may_s65@hotmail.com
Salama
Osama Saad
OS
Mansour
Fathy Awaad
FA
Hossein
Shaimaa
S
D000410:Alanine Transaminase; D001219:Aspartate Aminotransferases / Q000097:blood; D002648:Child; D015897:Comorbidity; D004534:Egypt / Q000453:epidemiology; D005260:Female; D006506:Hepatitis A / Q000150:complications*; D006508:Hepatitis Antibodies / Q000097:blood; D006509:Hepatitis B / Q000150:complications*; D006526:Hepatitis C / Q000150:complications*; D003699:Hepatitis D / Q000150:complications*; D016751:Hepatitis E / Q000453:epidemiology*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D008111:Liver Function Tests; D008297:Male; D011446:Prospective Studies; D016036:Seroepidemiologic Studies
D006508:Hepatitis Antibodies; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase