Non‐A to E hepatitis in children: Detecting a novel viral epidemic during the COVID‐19 pandemic
Abstract During the COVID‐19 pandemic, two further novel viral epidemics were described in 2022, monkeypox virus infections in men having sex with men and non‐A to E hepatitis in children. The latter occurred in the first half of 2022 with about 1000 cases worldwide, necessitating liver transplantat...
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| Format: | Article |
| Language: | English |
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Wiley
2023-10-01
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| Series: | Microbial Biotechnology |
| Online Access: | https://doi.org/10.1111/1751-7915.14329 |
| _version_ | 1827805602613559296 |
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| author | Harald Brüssow |
| author_facet | Harald Brüssow |
| author_sort | Harald Brüssow |
| collection | DOAJ |
| description | Abstract During the COVID‐19 pandemic, two further novel viral epidemics were described in 2022, monkeypox virus infections in men having sex with men and non‐A to E hepatitis in children. The latter occurred in the first half of 2022 with about 1000 cases worldwide, necessitating liver transplantation in 5% and causing death in 2% of patients. It took some effort to clarify the cause of the novel hepatitis epidemic. Researchers were confronted with a polymicrobial viral infection consisting of an adenovirus‐associated virus type 2 (AAV2) infection, co‐occurring with either human adenovirus type 41 (HAdV41) or herpesvirus infections; most prominently human herpesvirus type 6 (HHV‐6). AAV‐2, a small Dependovirus of the Parvovirus family, needs these helper viruses for its replication. AAV2 is used as a vector for liver‐targeting gene therapy but was not previously known to cause acute hepatitis. HAdV41 and HHV‐6 are mostly known to cause diarrhoea and febrile illnesses associated with skin rashes in children, respectively. Except for a few case reports of HHV‐6 hepatitis, HAdV and HHV‐6 are mostly known as major pathogens in immunosuppressed transplantation patients. A potential role of SARS‐CoV‐2 has also been discussed but the most popular hypothesis involves an indirect role of the COVID‐19 pandemic for this novel disease. Exposure to HHV‐6 infections occurs nearly quantitatively during the first year of life. Social distancing measures, followed by the lifting of these measures in 2022 might have caused a delayed exposure to multiple, normally benign childhood viral infections eliciting a dysregulated immune response with pathological effects for liver cells. In the fall of 2022, when these conditions were not longer met, case numbers dwindled. The hypothesis of an unequilibrated immune response instead of intrinsic cytopathic activity of the implicated viruses is further supported by the enrichment of a particular HLA allele in cases over controls. |
| first_indexed | 2024-03-11T21:27:33Z |
| format | Article |
| id | doaj.art-1a12793ae87640f58b40e0cf9b028329 |
| institution | Directory Open Access Journal |
| issn | 1751-7915 |
| language | English |
| last_indexed | 2024-03-11T21:27:33Z |
| publishDate | 2023-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | Microbial Biotechnology |
| spelling | doaj.art-1a12793ae87640f58b40e0cf9b0283292023-09-27T14:42:21ZengWileyMicrobial Biotechnology1751-79152023-10-0116101879188710.1111/1751-7915.14329Non‐A to E hepatitis in children: Detecting a novel viral epidemic during the COVID‐19 pandemicHarald Brüssow0Laboratory of Gene Technology, Department of Biosystems KU Leuven Leuven BelgiumAbstract During the COVID‐19 pandemic, two further novel viral epidemics were described in 2022, monkeypox virus infections in men having sex with men and non‐A to E hepatitis in children. The latter occurred in the first half of 2022 with about 1000 cases worldwide, necessitating liver transplantation in 5% and causing death in 2% of patients. It took some effort to clarify the cause of the novel hepatitis epidemic. Researchers were confronted with a polymicrobial viral infection consisting of an adenovirus‐associated virus type 2 (AAV2) infection, co‐occurring with either human adenovirus type 41 (HAdV41) or herpesvirus infections; most prominently human herpesvirus type 6 (HHV‐6). AAV‐2, a small Dependovirus of the Parvovirus family, needs these helper viruses for its replication. AAV2 is used as a vector for liver‐targeting gene therapy but was not previously known to cause acute hepatitis. HAdV41 and HHV‐6 are mostly known to cause diarrhoea and febrile illnesses associated with skin rashes in children, respectively. Except for a few case reports of HHV‐6 hepatitis, HAdV and HHV‐6 are mostly known as major pathogens in immunosuppressed transplantation patients. A potential role of SARS‐CoV‐2 has also been discussed but the most popular hypothesis involves an indirect role of the COVID‐19 pandemic for this novel disease. Exposure to HHV‐6 infections occurs nearly quantitatively during the first year of life. Social distancing measures, followed by the lifting of these measures in 2022 might have caused a delayed exposure to multiple, normally benign childhood viral infections eliciting a dysregulated immune response with pathological effects for liver cells. In the fall of 2022, when these conditions were not longer met, case numbers dwindled. The hypothesis of an unequilibrated immune response instead of intrinsic cytopathic activity of the implicated viruses is further supported by the enrichment of a particular HLA allele in cases over controls.https://doi.org/10.1111/1751-7915.14329 |
| spellingShingle | Harald Brüssow Non‐A to E hepatitis in children: Detecting a novel viral epidemic during the COVID‐19 pandemic Microbial Biotechnology |
| title | Non‐A to E hepatitis in children: Detecting a novel viral epidemic during the COVID‐19 pandemic |
| title_full | Non‐A to E hepatitis in children: Detecting a novel viral epidemic during the COVID‐19 pandemic |
| title_fullStr | Non‐A to E hepatitis in children: Detecting a novel viral epidemic during the COVID‐19 pandemic |
| title_full_unstemmed | Non‐A to E hepatitis in children: Detecting a novel viral epidemic during the COVID‐19 pandemic |
| title_short | Non‐A to E hepatitis in children: Detecting a novel viral epidemic during the COVID‐19 pandemic |
| title_sort | non a to e hepatitis in children detecting a novel viral epidemic during the covid 19 pandemic |
| url | https://doi.org/10.1111/1751-7915.14329 |
| work_keys_str_mv | AT haraldbrussow nonatoehepatitisinchildrendetectinganovelviralepidemicduringthecovid19pandemic |