Nature March 2023

ISARIC4C researchers worked closely with researchers led by Prof Judith Breuer at Great Ormond Street hospital and University College London. Samples from 28 children with hepatitis were tested, five of whom required liver transplants. High levels of AAV2 was detected in most of these children.

The results of this study supported and corroborated the results found in the Scottish children with acute hepatitis led by Prof Emma Thomson and the ISARIC4C researchers.

Both these two ISARIC4C studies on acute hepatitis in children were able to rule out recent or prior Covid infection as a direct cause for the acute hepatitis – although neither has been peer reviewed.

Since AAV2 cannot replicate without a “helper” virus, the researchers believe co-infection with a second virus – an adenovirus, or less often a herpes virus called HHV6 – may explain the onset of severe hepatitis.

Larger studies are still urgently needed to investigate the role of AAV2 in paediatric hepatitis cases as many unanswered questions remain.