Etiology, incidence and outcomes of acute hepatic failure in 0-18 year old Filipino children.
Data on the epidemiology of acute hepatic failure (AHF) among pediatric Filipinos is limited. This study investigated the etiology, outcomes and incidence of AHF among 0-18 year old Filipino children. A hospital-based retrospective and prospective surveillance study was conducted at Philippine General Hospital between January 2000 and December 2006. AHF was defined as onset of coagulopathy and/or encephalopathy < or = 28 days after the onset of symptoms, a patient/ laboratory prothrombin time >2, an elevated bilirubin level and evidence of liver failure complicated by encephalopathy. Blood samples were tested for viral hepatitis antibodies using ELISA (Abbott Lab). AHF incidence rates were calculated with 95% confidence intervals (CI). Twenty-seven subjects were recruited and 26 included in the analysis. The mean age of AHF subjects at the time of hospital admission was 6.9 years (SD:6.09 years). The most frequent etiological agents for AHF were hepatitis A virus (HAV) (19.2%; 5/26) and hepatitis B virus (3.8%; 1/26). Incidence of AHF was 11.05 per 100,000 subject years (95% CI 6.81-15.30). Jaundice was observed in 84.6% (22/26) of subjects and encephalopathy on admission (any grade) was reported in 72.0% of subjects: AHF was fatal in 84.6% (22/26) of subjects. HAV was the most common etiological agent for AHF. Indeterminate causes for AHF indicate the need for further investigation.
National Institutes of Health, University of the Philippines Manila, Manila, Philippines. lulucbravo@yahoo.com
Lulu C
LC
Bravo
Germana V
GV
Gregorio
Fakrudeen
F
Shafi
Hans L
HL
Bock
Irving
I
Boudville
Yanfang
Y
Liu
Salvacion R
SR
Gatchalian
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D016174:Hepacivirus; D006501:Hepatic Encephalopathy / Q000209:etiology; D030041:Hepatitis A virus; D006508:Hepatitis Antibodies; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007565:Jaundice / Q000209:etiology; D017114:Liver Failure, Acute / Q000150:complications* / Q000453:epidemiology* / Q000209:etiology / Q000821:virology; D008297:Male; D010679:Philippines / Q000453:epidemiology; D011446:Prospective Studies; D012189:Retrospective Studies
D006508:Hepatitis Antibodies