Clinicians should be aware of children who are likely to have protracted illness and require hospitalization stemming from norovirus acute hepatitis, according to the results of a recent study.1

The objective of the study was to explore the extraintestinal manifestation following norovirus infection, because of its rarity and the unknown mechanisms.

Investigators analyzed a review of English literature published from January 1967 to April 2019 to evaluate the risk of acute viral hepatitis stemming from norovirus gastroenteritis, with data sources including the Cochrane Library, Embase, and Medline.

One hundred and twenty-six potential studies were identified, including 5 publications involving 17 cases of norovirus-induced hepatitis, which all had elevated alanine aminotransferase and aspartate aminotransferase levels. Most of the individuals examined were younger than aged 18 years, and almost twothirds had supportive treatment, mainly intravenous fluid administration.

The average duration of illness was 10 days compared with 3 days in those without elevated transaminitis, as it took an average of 22.5 days for liver enzymes to settle. In addition, all patients recovered fully with no progression to chronic liver disease.

The investigators recommended that clinicians be aware of norovirus-induced transaminitis, as they reported that norovirus gastroenteritis is a self-limiting illness with the majority of patients not requiring hospitalization or invasive investigations.

  1. Ho CLT, Oligbu O, Asaid F, Oligbu G. Does norovirus induce acute hepatitis? AIMS Public Health. 2020;7(1):148-157. doi:10.3934/publichealth.2020013