Viral hepatitis B, C, and D in children - clinical, epidemiological and evolution aspects

Abstract

termine the epidemiological, diagnostic, clinical, developmental aspects and treatment of viral hepatitis B, C and D in children. Objectives: • to assess the role of the source in the transmission of infection with hepatitis B, C and D viruses in children. • to estimate evaluating the clinical and diagnostical particularities in patients with viral hepatitis B, C, D. Materials and methods: the study included 40 pacients diagnosed with acute/chronic HBV, HCV and HDV infection during the years 2001-2011, treated in IMSP Municipal Hospital of Contagious Diseases in Children, Chisinau. Patients were subjected to clinical examination, biochemical and serological analysis and to ultrasonography of the abdominal cavity organs, to esthablish clinical diagnosis. Results: the study included 22 girls and 18 boys, average age 10,4 ±5,1 years. Acording to the etiology, the clinical diagnosis of HVB was established in 28 (70%) cases, HVC in 8 (20%) cases and HVD in 4 (10%) cases. Typical type (icteric) was determined in 22 children, and the atypical type in 18. Acording to the evolution, there were determined the folowing types: acute in 24 (60%) cases, subacute in 4 (10%) cases and chronic in 12 (30%). Out of 37 children aged over 6 months, 8 (21,6%) children presented an anamnesis of surgical procedures, dental consultations and blood transfusions during the last 6 months and 2 teenagers had unprotected sexual relations with more than one partner. Epidemiological investigation in the context of maternal-fetal and habitual routes of transmission was relevant in 12 (30%) children. Conclusion: Epidemiological investigations established that the most frequent routes of transmission of viral hepatitis in children included in our study were the parenteral, perinatal and habitual ones. Polymorphic symptoms present in 45% of patients showed difficulties in establishing the clinical diagnosis of viral hepatitis. Both pregnant women and family members of the outbreak had to be investigated not only for HBsAg, but also for the presence of serological markers of hepatitis: anti-HB cor (IgM-i- IgG), anti-HCV (IgM+IgG) and anti-HVD (IgM+IgG).