Liver Transplant and Intensive Care Unit, Hospital de Pediatría Dr. J. P. Garrahan, Buenos Aires, Argentina.
Pediatr Crit Care Med. 2010 May;11(3):385-9. doi: 10.1097/PCC.0b013e3181ceadca.
To investigate the detection of hepatitis A virus ribonucleic acid in patients with acute liver failure and to assess if the results have any clinical implications for the evolution of acute liver failure in children. Hepatitis A infection, a vaccine-preventable disease, is an important cause of acute liver failure in children in Argentina. Universal vaccination in 1-yr-old children was implemented in June 2005.
Observational study in which patients were divided into Group 1 consisting of positive hepatitis A virus ribonucleic acid and Group 2 consisting of negative hepatitis A virus ribonucleic acid.
Pediatric intensive care unit in National Pediatric Hospital "Dr. J. P. Garrahan," Buenos Aires, Argentina.
Thirty-three patients with the diagnosis of acute liver failure secondary to hepatitis A virus infection and admitted to the Garrahan Pediatric Hospital between September 2003 and September 2005 were enrolled in the study. Twenty of these children were admitted to the pediatric intensive care unit.
None.
Samples for total ribonucleic acid detection and genotyping were obtained from serum and/or stools on admission. We found positive hepatitis A virus ribonucleic acid in 13 patients and negative hepatitis A virus ribonucleic acid in 20 patients. The following clinical variables were evaluated: time of evolution, hospital stay, admission to the pediatric intensive care unit, pediatric intensive care unit stay, time on mechanical ventilation, criteria for orthotopic liver transplantation, and mortality. Characterization of the isolates did not reveal differences related to genotype; all cases were IA. No statistical significance was found as to the variables. However, positive hepatitis A virus ribonucleic acid showed lower percentages of pediatric intensive care unit admissions, criteria for orthotopic liver transplantation, number of orthotopic liver transplantation, and mortality than the group of patients with negative hepatitis A virus ribonucleic acid.
Hepatitis A virus genotyping studies did not show any particularities, all cases were IA and, thus, apparent associations between genotype and the clinical presentation of acute liver failure could not be found.
探讨急性肝衰竭患者甲型肝炎病毒核糖核酸的检测，并评估其对儿童急性肝衰竭的演变是否具有临床意义。甲型肝炎感染是一种可通过疫苗预防的疾病，是阿根廷儿童急性肝衰竭的重要病因。2005 年 6 月，对 1 岁儿童实施了普遍疫苗接种。
将患者分为甲型肝炎病毒核糖核酸阳性的第 1 组和甲型肝炎病毒核糖核酸阴性的第 2 组的观察性研究。
阿根廷布宜诺斯艾利斯的国家儿科医院“J.P.加兰博士”儿科重症监护病房。
2003 年 9 月至 2005 年 9 月期间，因甲型肝炎病毒感染导致急性肝衰竭并入住加兰儿科医院的 33 例患者纳入研究。其中 20 例患儿入住儿科重症监护病房。
无。
入院时从血清和/或粪便中采集总核糖核酸检测和基因分型样本。我们在 13 例患者中发现了甲型肝炎病毒核糖核酸阳性，在 20 例患者中发现了甲型肝炎病毒核糖核酸阴性。评估了以下临床变量：病程时间、住院时间、入住儿科重症监护病房、儿科重症监护病房停留时间、机械通气时间、原位肝移植标准和死亡率。分离株的特征分析未显示与基因型相关的差异；所有病例均为 IA 型。各变量之间无统计学意义。然而，甲型肝炎病毒核糖核酸阳性组的儿科重症监护病房入住率、原位肝移植标准、原位肝移植次数和死亡率均低于甲型肝炎病毒核糖核酸阴性组。
甲型肝炎病毒基因分型研究未显示任何特殊性，所有病例均为 IA 型，因此，无法发现基因型与急性肝衰竭临床表现之间的明显关联。
