Efforts continue to determine the cause of the rising number of instances of acute hepatitis of unknown etiology in healthy children nationwide. Human adenoviruses (HAdV), namely HAdV F-41, are proposed as potential causes. This research examined the link between HAdV and acute hepatitis of unknown etiology in children in southwest Iran.

The study was conducted on children diagnosed with acute hepatitis of unknown etiology in the cities of Kerman and Yazd between February 20, 2023, and January 20, 2024. A standardized questionnaire was used to collect information on symptoms, and laboratory test results were also obtained. Blood and stool samples were obtained for viral detection using real-time PCR following DNA extraction.

This investigation consisted of 20 children diagnosed with acute hepatitis of unknown etiology. The children had a median age of 6.8±5.7 years, ranging from 8 months to 16 years, and 14 of these patients were male. Among the clinical symptoms, fever, diarrhea, and jaundice were the most common symptoms among patients. Aspartate aminotransferase (AST) and alanine transaminase (ALT) testing revealed values above 500 IU/L in 70% of the individuals. The HAdV genome was found in the samples of 20% of the patients, with three of four HAdV-positive isolates confirming the presence of HAdV F-41. Finally, 17 patients were discharged, two had a liver transplant, and one patient passed away.

A potential link between HAdV F-41 and acute hepatitis of unknown etiology is indicated. The results necessitate a revision of protocols to reduce complications.