Prevalence and outcome of children with acute viral hepatitis using complementary and alternative medications (CAM) presenting to a tertiary care center of North India: A prospective observational study

IF 1.9 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health Pub Date : 2026-03-01 Epub Date: 2026-02-18 DOI:10.1016/j.cegh.2026.102304

Prerna Priyadarshini , Sudhir Verma , Manisha Verma , Sanjeev Kumar Verma

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引用次数: 0

Abstract

Objective

The use of complementary and alternative medicine (CAM) is a widespread practice worldwide for treating a variety of health conditions. The impact of CAM related drug induced liver injury (DILI) in pediatric population is not known. Therefore, this study is planned to examine the prevalence of use of CAMs in children with acute viral hepatitis (AVH) and to describe the outcome of CAM related liver injury (second hit) in children with hepatitis A and E related AVH.

Methods

This prospective observational study included children aged 1 to 18 years with AVH who presented to a tertiary care center in North India between April 2024 and September 2024. Clinical and laboratory details were noted on a predesigned format, including detailed history of use of CAM. Groups of children with AVH with and without use of CAMs were compared.

Result

During the study period 78 patients with AVH presented to the Department of Paediatrics of which 60 were enrolled. Thirty-seven (62%) had history of CAM use in past. On univariate analysis, pruritus (p = 0.021), ascites (p < 0.001), hepatic encephalopathy (p = 0.021), and pediatric acute liver failure (PALF) (p = 0.001) were significantly more common among children with acute viral hepatitis who used complementary and alternative medicine (CAM). Variables found to be significant on univariate analysis were subjected to multivariate analysis. PALF (adjusted OR: 9.141; 95% CI: 1.526–54.764; p = 0.015) was independently associated with CAM use among children with AVH. The mortality rate among children with AVH who used CAM was 5.4% in this study.

Conclusion

The present study clearly highlights the high prevalence of CAM use in the pediatric population with AVH. Pruritus, ascites and PALF complicate, natural AVH course with CAM use.

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印度北部三级保健中心对急性病毒性肝炎患儿使用补充和替代药物（CAM）的患病率和结果：一项前瞻性观察研究

目的补充和替代医学（CAM）的使用是世界范围内治疗各种健康状况的广泛做法。CAM相关药物性肝损伤（DILI）对儿科人群的影响尚不清楚。因此，本研究计划检查急性病毒性肝炎（AVH）儿童使用CAM的流行程度，并描述甲型肝炎和戊型肝炎相关AVH儿童CAM相关肝损伤（二次打击）的结局。方法本前瞻性观察研究纳入了2024年4月至2024年9月在印度北部三级保健中心就诊的1至18岁AVH患儿。临床和实验室细节记录在预先设计的格式上，包括详细的CAM使用历史。比较使用CAMs和不使用CAMs的AVH患儿组。结果在研究期间，78例AVH患者到儿科就诊，其中60例入选。37人（62%）既往有CAM使用史。在单变量分析中，瘙痒（p = 0.021）、腹水（p < 0.001）、肝性脑病（p = 0.021）和小儿急性肝衰竭（p = 0.001）在使用补充替代药物（CAM）的急性病毒性肝炎患儿中更为常见。在单变量分析中发现显著的变量进行多变量分析。PALF（校正OR: 9.141; 95% CI: 1.526-54.764; p = 0.015）与AVH患儿使用CAM独立相关。在本研究中，使用CAM的AVH儿童死亡率为5.4%。结论本研究清楚地强调了儿童AVH人群中CAM的高患病率。瘙痒，腹水和PALF复杂，自然AVH病程与CAM使用。

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来源期刊

Clinical Epidemiology and Global Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

4.60

自引率

7.70%

发文量

218

审稿时长

66 days

期刊介绍： Clinical Epidemiology and Global Health (CEGH) is a multidisciplinary journal and it is published four times (March, June, September, December) a year. The mandate of CEGH is to promote articles on clinical epidemiology with focus on developing countries in the context of global health. We also accept articles from other countries. It publishes original research work across all disciplines of medicine and allied sciences, related to clinical epidemiology and global health. The journal publishes Original articles, Review articles, Evidence Summaries, Letters to the Editor. All articles published in CEGH are peer-reviewed and published online for immediate access and citation.