eISSN: 2449-8238
ISSN: 2392-1099
Clinical and Experimental Hepatology
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3/2024
vol. 10
 
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abstract:
Original paper

Varicella-zoster virus hepatitis – a rare complication of primary infection in immunocompetent children?

Maja Pietrzak
1
,
Maria Pokorska-Śpiewak
1

  1. Pediatric Infectious Diseases Department, Regional Hospital of Infectious Diseases in Warsaw, Warsaw, Poland
Clin Exp HEPATOL 2024; 10, 3: 170-175
Online publish date: 2024/09/16
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Aim of the study:
This research aimed to investigate the incidence and course of varicella-zoster virus hepatitis in immunocompetent children.

Material and methods:
Medical charts of children hospitalised between 2019 and 2022 (excluding the period of the COVID-19 pandemic) due to varicella were retrospectively analysed and compared.

Results:
In total, 216 children were included in the analysis. In 24 children (11.1%) alanine aminotransferase (ALT) levels were elevated, whereas in 192 (88.9%) children, ALT levels were within the normal range. In 19 patients, ALT levels exceeded the upper limit of normal (ULN) less than twofold, in 4 patients ALT levels were elevated 2-3-fold, and in only one infant, a value 9.4× ULN was observed. None of the patients developed liver failure. The median age at the time of the diagnosis was significantly higher in the group of patients with elevated ALT – 5.5 years vs. 3 years in the group with normal ALT values (p = 0.02). The median duration of fever and hospitalization was longer by 1 day in the group with elevated ALT. Additionally, varicella lesions lasted longer in this group, 7.5 days vs. 6 days in the group with normal ALT levels (p = 0.01). Although median C-reactive protein (CRP) and procalcitonin (PCT) values did not differ, median leukocyte values were lower (p = 0.01) in the group with elevated ALT (7.3 × 103/ml vs. 8.8 × 103/ml).

Conclusions:
Elevation of ALT during varicella is observed in 1 out of 10 immunocompetent patients. The course of this hepatitis is predominantly mild.

keywords:

varicella, hepatitis, chickenpox, alanine aminotransferase, VZV

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