BPSU - Acute Symptomatic Infectious Hepatitis in Hospitalised Children

Surveillance of acute symptomatic infectious hepatitis in UK and Irish children began in January 2014 and will continue for 13 months. Little is known about the epidemiology, causative agents, clinical features, risk factors, management or outcome of children with acute infectious hepatitis in industrialised countries.

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Shamez Ladhani.jpg

Lead investigator

Dr Shamez Ladhani
Immunisation, Hepatitis and Blood Safety Department
Public Health England
61 Colindale Avenue   
London NW9 5EQ

Tel: 0208 327 7155

Overview

Acute infectious hepatitis can be associated with significant morbidity and may be severe enough to cause liver failure and warrant liver transplantation. Most childhood cases are caused by viruses such as hepatitis A (HAV) and hepatitis B (HBV) viruses, although other pathogens can also be responsible. Effective vaccination against both HAV and HBV are available but not routinely used in the UK because these infections are considered to be rare.

This study aims to assess the burden of childhood hospitalisations for symptomatic acute infectious hepatitis, clinical characteristics, investigations, aetiology, management and short-term as well as long-term outcomes.

We hope that the results of our study will increase awareness of the condition among paediatricians and the public, help improve the way we manage children with acute infectious hepatitis and develop national strategies to prevent such cases occurring in the first place through, for example, routine immunisation.

Case Definition: An acute hepatitis in any infant or child aged 1 month up to 14 years of age with:

  1. discrete onset of symptoms (e.g. fever, jaundice, abdominal pain, fatigue, loss of appetite, nausea or vomiting); AND
  2. elevated serum alanine aminotransferase(ALT) levels (>2 x upper limit of normal); AND
  3. not due to drug-induced, metabolic or auto-immune hepatitis.
Duration: January 2014 to January 2015 (13 months of surveillance) with a 12 month follow-up questionnaire.
 
Funding: This study is funded by an unrestricted, investigator-initiated grant from GlaxoSmithKline (GSK) Biologicals who have no involvement in running the study and is taking place in collaboration with St. George’s University of London.
 
Ethical approval: This study has been approved by NRES Committee East of England - Cambridge Central (REC reference: 13/EE/0392; IRAS project ID: 114805). Public Health England has approval under Section 251 of the NHS Act 2006 under reference  ECC 6- 02(FT12)/2012 to process confidential patient information for public health purposes (see The Health Service (Control of Patient Information) Regulations 2002). 

Further information