Purpose: Acute viral hepatitis A is a widespread, usually self-limited disease in children. This study was conducted to see any change in the pattern of clinico-epidemiological and laboratory profile of this disease and to find out hepatic and extra-hepatic complication in children.   

Methodology: 43 children diagnosed as acute viral hepatitis A by HAV IgM serology (ELISA) were included in this Hospital based cohort study.

Results: Mean age was 6.65 ± 2.46 y (48.8% male, 51.2% female).29 children were from lower socio-economic status. Anicteric hepatitis was found in 6.98%. Fever, dark colored urine and hepatomegaly were present in all. Other signs and symptoms were icterus (93.02%), nausea (83.72%), vomiting (76.74%), pain abdomen, abdominal distention, clay colored stool, pruritus and splenomegaly (16.28%). Most common complication was prolonged (> 12 weeks) cholestasis (16.3%) followed by ascites (6.99%), bleeding manifestations (4.65%), fulminant hepatic failure (4.65%). By comparative study, in children with prolonged cholestasis and/or palpable left lobe of liver(20.9%) with the rest of the study populations: it showed that the serum bilirubin (mean14.48 mg/dl), AST( p 0.001)and ALP(p  0.008) value were much higher  with statistically significant hypoalbuminemia (p  0.042), edema (p 0.011), splenomegaly (p 0.008), altered hepatic echotexture (p 0.010),GB wall thickening (p 0.003) and altered ALT : AST ratio( p 0.005) at initial presentation.

Conclusion: This study showed that there is a changing trend in terms of increased frequency of prolonged cholestasis and left lobe hepatomegaly with significant changes of some relevant laboratory parameters.

Keywords: Hepatitis A, Cholestasis , Palpable left lobe of liver, Hypoalbuminemia, Cohort study

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Shibasish Banerjee

Demonstrator, Department of Community Medicine, Medical College, Kolkata, West Bengal, India