Etiology, incidence and outcomes of acute hepatic failure in 0-18 year old Filipino children.

Abstract

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.

• Authors: Lulu C Bravo, Germana V Gregorio, Fakrudeen Shafi, Hans L Bock, Irving Boudville, Yanfang Liu, Salvacion R Gatchalian
• Journal: The Southeast Asian journal of tropical medicine and public health (Southeast Asian J Trop Med Public Health) Vol. 43 Issue 3 Pg. 764-72 (May 2012) ISSN: 0125-1562 [Print] Thailand
• PMID: 23077857 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Hepatitis Antibodies

Topics

• Adolescent
• Child
• Child, Preschool
• Enzyme-Linked Immunosorbent Assay
• Female
• Hepacivirus
• Hepatic Encephalopathy (etiology)
• Hepatitis A virus
• Hepatitis Antibodies
• Humans
• Incidence
• Infant
• Infant, Newborn
• Jaundice (etiology)
• Liver Failure, Acute (complications, epidemiology, etiology, virology)
• Male
• Philippines (epidemiology)
• Prospective Studies
• Retrospective Studies