What is Hepatitis G in Children?
Hepatitis G is a disease similar to hepatitis C, they are transmitted in the same way.
Epidemiology
VGO is ubiquitous. The frequency of detection of BGG RNA (hepatitis G virus) clearly correlates with blood transfusions, multiple parenteral interventions. Under parenteral interventions understand operations associated with blood and mucous membranes.
At risk of hepatitis G infection are primarily drug addicts who use injections to inject drugs into the body. Also at risk are those receiving hemodialysis, blood donors. Chronic hepatitis C patients are also infected.
There is a chance of infection through sexual contact and vertical (the infection is transmitted from mother to fetus).
Causes of Hepatitis G in Children
According to the composition of the nucleotide and amino acid sequences, virus G together with HCV forms a group of hepatitis-associated viruses within the family of flaviviruses (Flavivindae).
The structure of BGG RNA corresponds to a scheme similar to the entire family of flaviviruses. The zone encoding structural proteins is at the 5th level. The non-structural protein coding region is at the 3rd end. The RNA molecule contains one open reading frame; encodes the synthesis of a precursor polyprotein of approximately 2,900 amino acids. The virus has constant sections of the genome (used to create primers used in the NDP), but also differs in significant variability, which is explained by the low reliability of the reading function of the viral RNA polymerase.
It is believed that the virus contains a nucleocapsid protein (aka core protein) and supercapsid proteins (aka surface proteins).
Different variants of the nucleotide sequences of BrG in different isolates are regarded as different subtypes within a single genotype or as intermediate between genotypes and subtypes. There are several VGO genotypes (GBV-C and BGG-prototype, etc.).
Pathogenesis during Hepatitis G in Children
A week after infection of the blood, serum BGG RNA can be detected. RNA titers can be low (up to 102 / ml) and high (up to 107 / ml), as evidenced by 9-year follow-up of individuals with persistent HBV infection (long-term in the body). Captions can be stable all the time during observation or fluctuate significantly. There have been cases of fixation of periodic disappearance in hepatitis G virus RNA serum samples.
Virus RNA is also found in the liver tissue. For the purpose of the experiment, hepatitis G virus was infected with chimpanzees. The animal developed liver damage, intralobular necrotic inflammatory changes and inflammatory infiltration along the portal tracts similar to hepatitis C.
Pathomorphology. Pathological changes in the liver tissue during infection with this virus are similar to those for hepatitis C.
Symptoms of Hepatitis G in Children
The disease manifests itself in a wide range of liver lesions – from acute cyclic hepatitis and chronic forms to asymptomatic carriage.
In acute mono infection, a slight increase in the temperature of the child, asthenodyspepsic symptoms (for example, lethargy, nausea, abdominal pain, sometimes vomiting) may appear. At the height of the symptoms, the liver becomes enlarged, and in more rare cases, the spleen. A blood test reveals an increased activity of AlAT and AsAT in serum. However, in most cases, the level of bilirubin does not exceed the norm. HBV RNA is detected in the blood serum.
Disease with the course can be acute, lingering and chronic. Moreover, the symptoms are as similar as possible with hepatitis C of a viral nature.
Acute hepatitis G usually ends with either recovery or, in the case of untimely detection and treatment, the formation of chronic hepatitis. If the infection is combined with hepatitis C, there is a chance of developing cirrhosis.
Diagnosis of Hepatitis G in Children
Hepatitis G is found using specific diagnostics, namely, the detection of virus RNA in serum. To do this, use the PCR method, which stands for polymerase chain reaction. This method is widely used in science (for example, in biology) and in medical practice. It helps to diagnose various hereditary and infectious diseases in children and adults. PCR is performed by taking blood. Less commonly, by taking urine or other biological material in which the virus is supposedly localized.
Another method for diagnosing BPG infection is an ELISA test to detect antibodies to the surface E2 HGV protein. ELISA stands for Enzyme Immunoassay. It reveals, unlike PCR, not the virus itself, but its “traces” in the biological material (blood, urine, breast milk, etc.).
Hepatitis G Treatment in Children
The general principles of treatment for hepatitis G are the same as for hepatitis C.
Hepatitis G is treated primarily with interferon alfa. The drug helps prevent infection of new liver cells. After administration, the body’s response to interferon is the same as that of a viral infection. Body temperature rises, a person notes weakness in the body, which is very similar to flu. But after 12 hours after administration of the drug, these symptoms disappear.
While treatment is underway, blood should be tested every month to determine the dynamics of liver inflammation (decrease, stability or increase). Interferon does not guarantee recovery by 100%, but such treatment can prevent cirrhosis and liver cancer.
To increase the effectiveness of treatment, ribavirin is often prescribed with interferon. Recovery through this combination of drugs occurs in 40-60 cases out of 100. The lack of effectiveness of interferon is due to differences in its concentration in the blood during administration three times a week.
Recently, in order to enhance the effectiveness of interferon, a pegylation process has been used. This is the addition of a non-toxic inert polyethylene glycol to the interferon molecule, which enhances the activity of biologically active proteins. Pegylated interferon is usually administered once every 7 days – this is enough to maintain a sufficient concentration of the substance in the blood.
When the course of treatment is completed, another few months conducting a blood test due to the appearance of signs of liver inflammation in some patients at the end of taking interferon.
Prevention of Hepatitis G in Children
A set of the same measures is being taken as to prevent other viral hepatitis with a parenteral route of infection / transmission.