Acute hepatitis of unknown etiology in children: Comparison between the U.K., U.S., and Japan, and ingenious clinical practice attempts

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  • Sumazaki Ryo
    Ibaraki Children's Hospital The Research Center for Hepatitis and Immunology, National Center for Global Health and Medicine
  • Sakai Aiko
    Department of Viral Pathogenesis and Controls, National Center for Global Health and Medicine
  • Mushiake Sotaro
    Department of Pediatrics, Kindai University Nara Hospital
  • Kondou Hiroki
    Department of Pediatrics, Kindai University Nara Hospital
  • Inui Ayano
    Department of Pediatric Hepatology and Gastroenterology, Saiseikai Yokohama-city Tobu Hospital
  • Kawada Junich
    Department of Pediatrics, Nagoya University Graduate School of Medicine

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Other Title
  • 原因不明の小児急性肝炎：欧米と日本の比較並びに診療支援システムの整備
  • ゲンイン フメイ ノ ショウニ キュウセイ カンエン : オウベイ ト ニホン ノ ヒカク ナラビニ シンリョウ シエン システム ノ セイビ

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Abstract

<p>In 2022, cases of pediatric acute hepatitis of unknown origin increased in the United Kingdom. Initially, with the relaxation of Coronavirus disease 2019 measures, adenovirus's prevalence was noted. Moreover, metagenomic analysis suggested that adeno-associated virus type 2 (AAV2) was the causative agent; high levels of AAV2 were detected in many affected children. HLA-DRB1*04:01 was also detected, indicating a possible genetic predisposition. Acute liver failure sometimes occurs with gene therapy using intravenous infusion with AAV9 vectors, which might be a related condition. Some cases of hepatitis are also caused by sever acute respiratory syndrome coronavirus 2. In Japan, postpandemic pediatric hepatitis cases have not increased compared to prepandemic cases, and AAV2 has rarely been detected-differing from the reports and results from the United Kingdom and United States. Historically, approximately 40% of pediatric acute liver failure cases have an unknown origin, and AAV is presumed to be involved in some of these cases.</p>

Journal

  • Kanzo

    Kanzo 65 (1), 1-11, 2024-01-01

    The Japan Society of Hepatology

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