الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Comparable to other major infectious illnesses, including tuberculosis, HIV/AIDS, and malaria, viral hepatitis poses a significant threat to public health worldwide. In addition, the absolute burden of viral hepatitis is growing over time. Between 1990 and 2013, deaths from viral hepatitis globally had increased from 0.89 million to 1.45 million. In 2013, viral hepatitis was the seventh leading cause of death worldwide, whereas it was ranked 10th in 1990. Moreover, according to recent studies, liver disease is the main cause of mortality in Egypt, where mathematical models predict an increase in cases of liver cirrhosis and liver cancer related to the hepatitis viral infections in the coming decades (WHO, 2016; Elbahrawy et al., 2021 and Hassanein et al., 2022).
The World Health Organization (WHO) stated that hepatitis viral infection is a silent killer, where 1 in 3 people in the world has been infected by either HBV or HCV, in addition, these two viruses were accounted for almost 96% of the death cases which related to hepatic viral infections . The harm of viral hepatitis infection lies in its silent infection, as many infected people are not detected because of the absence of symptoms on them or the similarity of symptoms - if they appear - with other diseases, and often the infection is detected by chance through routine examinations by doctors (WHO, 2012)
When referring to children, their chance of being exposed to chronic infection is great, and then the other serious consequences of cirrhosis and liver tumors, and sometimes even up to liver transplantation or death in the case of ignoring this silent infection (Modin et al., 2019; Indolfi et al., 2019 and Kumar et al., 2023).
In the present study, an investigation has been done to find out the sero-prevalence of silent (hepatitis A, B, C, and E) viral infection and co-infection among some of hospitalized children in Cairo, Egypt. Which have done by collecting blood samples from three different hospitals (El Demerdash hospital, Sayed Galal hospital, and El Hussein university hospital) in Cairo, Egypt. The study was conducted from March to August 2019 on 184 random selected children patients. The children aged between few months to 15 years.
Patients’ medical history had been taken from their relative hospital from patients medical records. Laboratory investigation tests including; serological tests (ELISA) for (HAV IgM, HEV IgM, HBs Ag, and HCV Ab), liver enzymes (ALT, AST, and ALB), in addition to complete blood count have been performed to all tested subjects. Samples preparation and ELISA have been done at National research centre (NRC), Giza, Egypt. When ELISA tests gave positive results, the viral load was quantified using real time-PCR process.
The results obtained from this study could be summarized in the following points:
from the 184 random selected hospitalized paediatric patients, only Five children were confirmed to be positive for HCV Ab which was performed by using ELISA and confirmed to be positive by HCV RNA RT-PCR by Taqman probe as well, without any co-infections with other viruses (A, B, and E).
The other 179 children patients were found to be negative for all hepatitis viruses (A, B, C, and E) infections.
The sero-positivity of HCV infection in males was (40%) 2 boys, while in females was (60%) 3 girls. Relationship between positive HCV infection and gender has been done and showed non-significant relation with P-value 0.3778 (NS).
Relationship between positive HCV individuals and complete blood count parameters has been studied and showed only significance with haemoglobin levels with P-value 0.0034* , while it was non-significant with leukocyte count and PLT with P-value (0.9991 , 0.5652 respectively).
Relationship between positive HCV individuals and liver functions has been studied and showed only significance with ALT levels with P-value < 0.0001** , while it was non-significant with AST and Albumin with P-value (0.1176 , 0.701 respectively).
In addition, Albumin was lower in HCV positive children patients than the HCV negative children patients, but without any significant value.
There was a strong significant relationship between HCV infection and thalassemia positivity screening with P-value <0.0001** , where 3 of 5 HCV positive children patients were thalassemic patients.
Relationship between HCV infection and the four patients’s age groups (0-3), (4-7), (8-11), (12-15) has been studied and showed non-significant difference between HCV infection and children age.
Overall results have clearly shown that, very low incidences of hepatitis (A, B, C, and E) viral infection in Cairo hospitals that deal with paediatric patients have been observed. However, more studies with larger sample size of children patients and different areas in Egypt are needed, in order to control and avoid the chronic infection in early stage.