New Study Links Common Virus Co-Infections to Acute Severe Hepatitis Outbreak in Children After Covid-19 Lockdowns Eased
A new study published in the journal Nature has shed light on the causes of a peculiar outbreak of acute severe hepatitis in otherwise healthy children that began appearing after Covid-19 lockdowns eased in the United States and 34 other countries in the spring of 2022. The disease has been associated with the simultaneous co-infections of multiple common viruses, especially adeno-associated virus type 2 (AAV2), which typically doesn’t cause hepatitis by itself. AAVs need the help of other viruses, such as adenoviruses that cause colds and flus, to replicate in the liver.
The study, led by researchers at the University of Glasgow, found that the common virus AAV2 was present in a range of different samples taken from children with acute unexplained hepatitis. Recent studies indicate that AAV2 may be involved in the development of the illness. Without the presence of a “helper” virus like adenovirus or herpesvirus, this prevalent virus in childhood is unable to replicate itself. The researchers discovered that AAV2 was prevalent in almost all the children who had unexplained acute hepatitis, and a significant number of them had been infected with several helper viruses. Scientists discovered AAV2 in the blood and livers of affected children during small-scale British studies. Additionally, a number of individuals were found to have contracted either an adenovirus or herpes virus.
According to the research published in Nature, the disease has been associated with the simultaneous co-infections of multiple common viruses, especially adeno-associated virus type 2 (AAV2), which typically doesn’t cause hepatitis by itself. AAVs need the help of other viruses, such as adenoviruses that cause colds and flus, to replicate in the liver. According to the authors, the findings indicate that liver disease may be more severe when an individual is co-infected with AAV2, compared to being infected with either adenovirus or herpesvirus alone.
From 2022 onwards, there have been over 1,000 instances of hepatitis affecting children, characterized by liver inflammation, in 35 countries, which include the United States and the United Kingdom, and for which no specific cause has been identified. There were instances where the hepatitis was extremely severe, necessitating a liver transplant, while a smaller category of cases resulted in fatalities. Cases of severe acute hepatitis and liver failure are perplexing to specialists because they are exceedingly uncommon in children who are otherwise healthy. Since autumn 2021, the Centers for Disease Control and Prevention in the United States have probed 390 instances across 46 states. Out of the twenty-two children who required a liver transplant, thirteen have passed away. The World Health Organization reports approximately 1,000 cases worldwide.
Although the clusters of acute severe hepatitis in children have recently declined, frequent handwashing and staying home when sick are still advised to protect children from developing this frequently debilitating disease. According to the research, kids are more susceptible to contracting common pathogens after resuming their schooling. In addition, it was discovered by scientists that a select group of these kids could have developed a higher vulnerability to severe hepatitis due to obtaining numerous infections simultaneously.
Discovering the mechanism is crucial for effective treatment. Antivirals would be appropriate if AAV2 is the cause. If an atypical immune response is the cause, medications that suppress the immune system may be required. More studies are needed to understand how AAV2 infection alone, or with another virus, might affect liver cells, researchers recommend. The study, supported by the CDC, was carried out by researchers who utilized polymerase chain reaction (PCR) and a range of metagenomic sequencing and molecular testing approaches. They examined plasma, whole blood, nasal swab, and stool samples from 16 pediatric cases spanning six states, namely Alabama, California, Florida, Illinois, North Carolina, and South Dakota, during the period of October 1, 2021, to May 22, 2022. A total of 113 control samples were used for comparison with the specimens.
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