Glasgow scientists have discovered a virus that could be behind an outbreak of severe hepatitis in young children.
High levels of the bug, adeno-associated virus two (AAV2), were found in samples provided by all children diagnosed with unexplained hepatitis; inflammation of the liver. It was thought that it might have been linked to Covid-19, but the study proves that to be untrue.
Since April 2022, a number of young children worldwide have developed jaundice and acute severe hepatitis of unknown origin. In Scotland one child who contracted the bug needed a liver transplant, nine children in total were examined for the study.
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Most of those Scottish children suffered from diarrhoea, vomiting and abdominal pain between one and 11 weeks before showing severe liver inflammation in hospital. In the UK as a whole, most of the 268 cases were under the age of five with almost half of hospitalised cases (40 per cent, 74 of 189) being admitted to intensive care.
Two independent studies took place, in Glasgow and London. The Glasgow study was carried out at the MRC-University of Glasgow Centre for Virus Research (CVR) and the Royal Hospital for Children in Glasgow.
Professor Emma Thomson, clinical professor and consultant in Infectious Diseases at the MRC-University of Glasgow Centre for Virus Research (CVR) was the senior author of the Scottish study. She warned that there are still 'many unanswered questions'.
Professor Thomson added: “The presence of the AAV2 virus is associated with unexplained hepatitis in children. AAV2 may cause disease itself or it may be a useful biomarker of recent adenovirus infection which may be the main underlying virus, but which can be harder to detect.
"There are many unanswered questions and larger studies are urgently needed to investigate the role of AAV2 in paediatric hepatitis cases. We also need to understand more about seasonal circulation of AAV2, a virus that is not routinely monitored.
"It may be that a peak of adenovirus infection has coincided with a peak in AAV2 exposure, leading to an unusual manifestation of hepatitis in susceptible young children.”
Meanwhile Dr Antonia Ho, clinical senior lecturer and consultant in Infectious Diseases at the MRC-University of Glasgow Centre for Virus Research, said: “It is critical to interpret our findings in relation to the timeframe of the patients’ clinical presentation. Most of the Scottish children had a preceding illness with diarrhoea, vomiting and abdominal pain, often associated with adenovirus infection, between one to 11 weeks prior to presenting to hospital with acute liver inflammation.
"This may explain why adenovirus has not been identified in all affected children. The temporal association between adenovirus/ HHV6 and AAV2 infections requires further study.”
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