Could Herpesviridae be the cause of severe acute hepatitis of unknown origin in children?

• Published in: Expert review of anti-infective therapy Vol. 22; no. 1-3; p. 5
• Main Authors: Villar, Livia Melo, da Silva, Lucas Lima, do Lago, Barbara Vieira, Pereira, Jessica Gonçalves, Guimarães, Ana Carolina Silva, Mello, Francisco Campello do Amaral, de Paula, Vanessa Salete
• Format: Journal Article
• Language: English
• Published: England 2024
• Subjects: Acute Disease; Child; Diagnosis, Differential; Hepatitis; Herpesviridae; Humans; Virus Diseases; pathogenesis; viral hepatitis; Severe acute hepatitis; children; herpesvirus
• ISSN: 1744-8336
• DOI: 10.1080/14787210.2024.2304637

Severe acute hepatitis (SAH) is defined by a severe inflammation of hepatocytes in the liver parenchyma which can lead to an acute liver failure, a clinical condition with high mortality rate that can be triggered by several factors but is usually associated to hepatotropic viruses' infection. In 2022, cases of children with severe acute hepatitis of unknown origin hospitalized in Glasgow, Scotland, were reported. Possible causes of this condition include, but are not limited to, undiagnosed viral (and non-viral) infections, autoimmune hepatitis, drug and/or chemical toxicity, mitochondrial chain respiratory and metabolic disorders. Herpesviruses can cause severe acute hepatitis, but little is known about the role and the mechanisms of herpesviruses as a causative agent of this type of hepatitis. We review the role of herpesviruses as causative agent of SAH in children and other possible mechanisms involved in this disease. Differential diagnosis for herpesvirus in SAH should be implemented in all settings. Alternative fluids, such as saliva and dried blood, could be used in the diagnosis to overwhelm the availability of biological specimens at sufficient volume. In the future, genetic studies could also be added to increase the knowledge about severe acute hepatitis in children.