Co-infection of common viruses likely cause of rise in childhood hepatitis

Researchers believe that co-infection with two viruses – AAV2 and an adenovirus, and in some children, the herpes virus HHV6 - could be behind more than a thousand cases of sudden onset of liver disease in young children across 35 countries since last April.

Of those children in the UK who developed hepatitis, nearly 40 per cent were admitted to hospital, while a total of 12 needed a lifesaving liver transplant.

Teams from MRC-University of Glasgow’s Centre for Virus Research (CVR) and the Royal Hospital for children in Glasgow, Great Ormond Street Hospital and the UCL Great Ormond Street Institute of Child Health, who investigated the cause behind the cases, think that a period of lockdown may have contributed to a peak in adenovirus infections in the general public and meant children have lower immunity to certain viruses.

Previously, health experts had wondered whether Covid could be behind the surge in liver disease in children, however the research, which was in partnership with Public Health Scotland and the UK Health Security Agency, has now disproved the theory.

One of the researchers, Judy Breuer, Professor of virology at UCL GOS ICH, said, ‘While we still have some unanswered questions about exactly what led to this spike in acute hepatitis, we hope these results can reassure parents concerned about Covid-19 as neither teams have found any direct link with SARS-CoV-2 (Covid-19) infection. Our data does, however, point to AAV2 (adeno-associated virus) in the liver and, or blood of cases as the strongest biomarker for the hepatitis. 

'Additionally, the presence of HHV6 (herpes virus) and Adenovirus in the damaged livers, removed from five children who needed liver transplants, raises questions as to the role of co-infections with these three viruses in the most severe cases.’