[Acute viral hepatitis in children]. / Hépatites virales aiguës de l'enfant.

ABSTRACT

In children with acute hepatitis the main concern is to identify the cause since prognosis and therefore management largely depend on the specific causative agent. Since HAV is the most frequent in children, it should be investigated first. If there are no IGM anti-HAV antibodies, hepatitis B should be investigated. The value of anti-HCV antibodies, during acute hepatitis is not clear. Whatever the virus, severe evolution may occur, and symptoms of poor significance must be detected early. There is no risk of chronic evolution for hepatitis A. Follow-up studies of patients with hepatitis B should be performed to ensure clearance of HBSAg or to recognize the development of a chronic carrier state. Preventive measures include a search for a chronic carrier in the family and vaccination of the negative sibling or parents. In infancy, the diagnosis of "neonatal hepatitis" must be asserted by the presence of serological markers of viral infection. In the absence of such markers, other causes of cholestasis in infancy must be investigated. Perinatal transmission of hepatitis B virus should be now prevented by screening for women from high-risk groups and administration of immunoglobulins and vaccine to the neonates.