Two scientific studies on Monday shed new light on the cases of hepatitis, serious inflammation of the liver, having affected very young children in many countries in recent months, but remaining unexplained so far.
Just over 1,000 cases have been recorded in 35 countries, according to the World Health Organization (WHO), and 22 deaths. The majority of affected children are under the age of six, and some 5% of them have required liver transplants.
Both studies, which have not yet been peer-reviewed, concluded that a Covid-19 infection was not responsible. The coronavirus was not detected in the livers of the sick children studied, and the proportion of them showing antibodies against Covid-19 was similar to that of children not affected by these hepatitis.
Read also: Outbreak of acute hepatitis of unknown origin in children in Europe
Co-infection with two viruses
Conducted by scientists in Scotland and England respectively, these studies point to another culprit: a common virus called AAV2 (adeno-associated virus 2), detected at high levels in sick children. This virus is not normally known to cause disease. It cannot replicate itself, and for this it needs another virus, an adenovirus, or more rarely the herpes virus (HHV6).
Researchers believe that the co-infection of two viruses (AAV2 and an adenovirus, or HHV6) is currently the best explanation for these cases of hepatitis. “I think this is a plausible explanation for these cases,” said Deirdre Kelly, a professor of pediatric hepatology at the University of Birmingham, who was not involved in these studies, in a statement. “It seems that co-infection plays a key role.”
Several outstanding questions
“But it is still not understood why some children develop severe cases of the disease requiring a transplant. Could one possibility be co-infection with more than one virus?” she added.
Scientists also do not clearly understand why these cases are appearing precisely now. One hypothesis is that the confinements linked to the coronavirus have had an influence, for example by modifying the usual circulation of other viruses, or by preventing children from creating certain defenses against viruses with which they have been less confronted.
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