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Original Research

RMJ. 2009; 34(1): 36-39

Are there Reasons for Universal Immunization for Hepatitis A Virus Infection?

Munir I Malik, MD¶, Muhammad Shahid¤, Salma Naheed, Ali Yawar Alam*, Ejaz A Khan.


Objective: To determine the demographic, clinical, laboratory features and outcome of
Hepatitis A Virus (HAV) infection in children and young adults seen at Shifa
International Hospital, Islamabad, Pakistan.
Methods: We analyzed all cases of Hepatitis A infection at Shifa International Hospital
(SIH), Islamabad over a three-year period from October 2002 to December 2005. HAV
immunoglobulin M (IgM) was used as a marker of acute infection. Data regarding
demographic, laboratory investigations, morbidity and complications were collected.
Results: A total of 185 patients presented with acute HAV infection during the study
period. Mean age was 11.5±7.3 years (range 2-34) with 26% >16 years of age. There
were 66% males and 68% were students (including 2.5% physicians or medical students).
Sixty-five percent belonged to middle socioeconomic class, 20% to high and 6% to low
socioeconomic class. Eighty-one percent patients were from Rawalpindi/Islamabad area
and 73% cases occurred during July to December months. Clinical symptoms included
jaundice (80%), fever (45%), vomiting (62%), abdominal pain (43%), tender
hepatomegaly (21%) and diarrhea (9%). Mean duration of symptoms before diagnosis
was 6±4 days. There was history of contact in only 7% patients. The mean total bilirubin
was 5.9±7mg/dl and serum alanine aminotransferase (ALT) 1805±1642 mg/dl.
Hospitalization was required in 30% patients and 57% of these were of age >12 years.
Mean duration of hospitalization was 2.9±2.6days. There was a statistically significant
difference between those 15 yrs in terms of mean ALT

Key words: Hepatitis A virus, hepatitis, children.

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