IMPACT OF BASELINE NUTRITIONAL STATUS ON CLINICAL OUTCOMES OF ACUTE HEPATITIS A VIRUS INFECTION IN PEDIATRIC PATIENTS: A RETROSPECTIVE COHORT STUDY
Keywords:
Hepatitis A, Pediatrics, Nutritional Status, Malnutrition, Iraq, Clinical Outcomes, Cohort Study, Liver Function TestsAbstract
Background: Hepatitis A virus (HAV) remains a significant public health concern in regions with variable sanitation, including parts of Iraq. While often milder in children, its clinical course can be influenced by host factors, notably nutritional status. Malnutrition is also prevalent in many areas’ endemic for HAV.
Aim: This study investigates the association between baseline nutritional status and the severity and outcomes of acute HAV infection in children treated in Baghdad.
Methods: A retrospective cohort study was conducted using medical records from the Central Teaching Hospital of Pediatrics, Baghdad, Iraq. Children aged 1 to 14 years admitted with serologically confirmed acute HAV infection (positive anti-HAV IgM) between January 3, 2022, and December 29, 2024, were included. Baseline nutritional status was assessed using World Health Organization (WHO) anthropometric Z-scores (Weight-for-age [WAZ], Height-for-age [HAZ], Weight-for-height [WHZ]) calculated from admission data
Results: A total of 186 children met the inclusion criteria. Of these, 112 (60.2%) were classified as well-nourished and 74 (39.8%) as malnourished (including moderate and severe forms). The mean age was 6.8 ± 3.1 years, with no significant difference between groups. Malnourished children exhibited significantly higher peak TBil (12.8 ± 5.1 mg/dL vs. 8.9 ± 3.9 mg/dL, p < 0.001) and peak ALT (1850 ± 750 IU/L vs. 1350 ± 620 IU/L, p < 0.001) compared to well-nourished children.
Conclusion: In this cohort of pediatric patients with acute HAV infection, baseline malnutrition was significantly associated with increased biochemical severity, prolonged clinical course, longer hospital stays, and a higher rate of complications. Nutritional status appears to be a critical determinant of HAV outcomes in children.
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