title: Acute Viral Hepatitis in Pediatric Age Groups.
abstract: BACKGROUND
  Our clinical experience showed that there has been no decrease in pediatric cases of acute viral hepatitis in Kathmandu. The objective of the study was to analyze the etiology, clinical features, laboratory parameters, sonological findings and other to determine the probable prognostic factors of Acute Viral Hepatitis in pediatric population.
  
  
  METHODS
  Consecutive patients of suspected Acute Viral Hepatitis, below the age of 15 years, attending the liver clinic between January 2006 and December 2010 were studied. After clinical examination they were subjected to blood tests and ultrasound examination of abdomen. The patients were divided in 3 age groups; 0-5, 5-10 and 5-15 years. Clinical features, laboratory parameters, ultrasound findings were compared in three age groups.
  
  
  RESULTS
  Etiology of Acute Viral Hepatitis was Hepatitis A virus 266 (85%), Hepatitis E virus in 24 (8%), Hepatitis B virus in 15 (5%). In 7(2%) patients etiology was unknown. Three patients went to acute liver failure but improved with conservative treatment. There was no statistical difference in most of the parameters studied in different age groups. Ascites was more common in 5-10 years age group. Patients with secondary bacterial infection, ultrasound evidence of prominent biliary tree and ascites were associated with increased duration of illness. Patients with history of herbal medications had prolonged cholestasis.
  
  
  CONCLUSIONS
  Hepatitis A is most common cause of Acute Viral Hepatitis in pediatric population. Improper use of herbal medications, secondary bacterial infection and faulty dietary intake was associated with prolonged illness. Patients with prominent biliary radicals should be treated with antibiotics even with normal blood counts for earlier recovery.
authors.affiliation: Liver Unit, Department of Medicine, Bir Hospital, National Academy of Medical Sciences, Kathmandu, Nepal, 2Department of Medicine, Bir Hospital, National Academy of Medical Sciences, Kathmandu, Nepal.
authors.forename: Sudhamshu
authors.initials: S
authors.lastname: Kc
authors.affiliation: Liver Unit, Department of Medicine, Bir Hospital, National Academy of Medical Sciences, Kathmandu, Nepal, 2Department of Medicine, Bir Hospital, National Academy of Medical Sciences, Kathmandu, Nepal.
authors.forename: Dilip
authors.initials: D
authors.lastname: Sharma
authors.affiliation: Liver Unit, Department of Medicine, Bir Hospital, National Academy of Medical Sciences, Kathmandu, Nepal, 2Department of Medicine, Bir Hospital, National Academy of Medical Sciences, Kathmandu, Nepal.
authors.forename: Nandu
authors.initials: N
authors.lastname: Poudyal
authors.affiliation: Liver Unit, Department of Medicine, Bir Hospital, National Academy of Medical Sciences, Kathmandu, Nepal, 2Department of Medicine, Bir Hospital, National Academy of Medical Sciences, Kathmandu, Nepal.
authors.forename: Bhupendra Kumar
authors.initials: BK
authors.lastname: Basnet
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000208:Acute Disease; D000293:Adolescent; D000367:Age Factors; D000410:Alanine Transaminase / Q000097:blood; D000855:Anorexia / Q000209:etiology; D001201:Ascites / Q000209:etiology; D001219:Aspartate Aminotransferases / Q000097:blood; D001663:Bilirubin / Q000097:blood; D002648:Child; D002675:Child, Preschool; D060085:Coinfection / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D005334:Fever / Q000209:etiology; D006506:Hepatitis A / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D006509:Hepatitis B / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D016751:Hepatitis E / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D006525:Hepatitis, Viral, Human / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000821:virology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007565:Jaundice / Q000209:etiology; D008099:Liver / Q000000981:diagnostic imaging*; D008297:Male; D009325:Nausea / Q000209:etiology; D009390:Nepal / Q000453:epidemiology; D028321:Plant Preparations / Q000627:therapeutic use; D011537:Pruritus / Q000209:etiology; D012307:Risk Factors; D012709:Serum Albumin; D013997:Time Factors; D014463:Ultrasonography; D014839:Vomiting / Q000209:etiology
chemical_list: D028321:Plant Preparations; D012709:Serum Albumin; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D001663:Bilirubin
keywords: acute viral hepatitis; hepatitis A; hepatitis E; herbal medications.