The mysterious pediatric hepatitis elucidated

British researchers believe they have elucidated the wave of mysterious pediatric hepatitis observed in recent months. They would be linked to the pandemic, but not to SARS-CoV-2, the coronavirus responsible for COVID-19.

Mathieu Perreault
The Press

“An adenovirus which is normally benign circulates much more because of the end of confinement”, explains Fernando Alvarez, director of the liver transplant program at CHU Sainte-Justine and professor at the Faculty of Medicine at the University of Montreal. “In some genetically susceptible children, this adenovirus causes this kind of hepatitis. »

Abnormal pediatric hepatitis has mainly affected Great Britain. There have been no cases at Sainte-Justine or the Montreal Children’s Hospital, but the Public Health Agency of Canada has reported three cases in Quebec and seven elsewhere in Canada. The U.S. Centers for Disease Control and Prevention (CDC) recently reported that rates are barely above normal, and the same is true in Canada, according to Dr.^r Alvarez.

Researchers from the University of Glasgow, who publish their results on the pre-publication site MedRxiv, explain that two adenoviruses are involved.

The first adenovirus causes few symptoms and protects against the second, which is even more benign, except in those cases of genetic vulnerability. “It’s cross-protection,” says Dr.^r Alvarez.

“We see cases of hepatitis linked to this adenovirus in adults who are immunosuppressed, and also more rarely in people who have this genetic vulnerability, says Dr.^r Alvarez. There is also acute hepatitis A which lasts longer in people who have this genetic vulnerability. »

The Scottish researchers found this vulnerability in 89% of the little patients whose genetic analysis was done, compared to 17% in the general population.

This adenoviral hepatitis has struck 268 British children since April and more than 700 others elsewhere in the world. More than half of the patients are under 5 years old and 40% must be hospitalized.