الفهرس 
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Abstract
Diarrhea is one of the most common health issues, particularly in developing nations. Virus gastroenteritis is the most common cause of hospitalization for newborns and older children with severe dehydration caused by diarrhea; it is also a cause of infant death. In these patients, Rotavirus infections are the most common cause. However, the clinical implication of hepatic involvement and elevated level of liver enzymes in children with acute gastroentritis is uncertain.
Therefore, the aims of the present study were to evaluate Alanine aminotransferase and Aspartate aminotransferase levels in children with Rotavirus positive acute gastroenteritis and Rotavirus negative acute gastroenteritis and to evaluate their relation on clinical outcome.
This cross sectional study included 184 cases with acute gastroenteritis below 5 years of age. Patients were divided according to Rotavirus infection into two groups; the Rotavirus positive group that represented 40.2% (74 cases) and the Rotavirus negative group that represented 59.8% (110 cases). They were recruited and assessed for eligibility from pediatric out-patient clinics, Beni-Suef university hospitals.
Regarding the demographic characteristics of the gastrointestinal cases, the present study demonstrated that the mean age of the studied cases was 20.76±15.81 months, 50.5% of them were males and 49.5 were females, moreover, 54.3% of them were from rural residence. The comparison between the Rotavirus positive group and Rotavirus negative group regarding age and gender revealed no statistically significant differences between the studied groups (P value>0.05). Regarding residence, the present study indicated a statistically significant increase in Rotavirus positive patients from rural area (p value=0.041).
Regarding disease severity, the present study demonstrated a statistically significant increase in hospitalization among Rotavirus positive patients in comparison with Rotavirus negative patients (P value=0.042). There was a statistically significant increase in severe dehydration, incidence of vomiting and frequency of diarrhea among Rotavirus positive patients in comparison with Rotavirus negative patients (P value<0.01). Regarding severity score, the present study demonstrated a statistically significant increase in severe score among Rotavirus positive patients in comparison with Rotavirus negative patients (39.2% vs. 20.9%, respectively) (P value=0.023).
Regarding seasonal variation, the present study indicated that a statistically significant increase in Rotavirus infection during spring and autumn representing 55.8% and 32.4%, respectively (P value<0.0001).
Regarding liver enzymes, the present study demonstrated a statistically significant increase in ALT among Rotavirus positive patients in comparison with Rotavirus negative patients (38.69 ±16.897 IU/L vs. 25.82 ±8.24 IU/L, respectively) (P value<0.0001). The present study demonstrated a statistically significant increase in AST among Rotavirus positive patients in comparison with Rotavirus negative patients (64.80± 31.400 IU/L vs. 32.94 ±10.498 IU/L, respectively) (P value<0.0001) which is referred to as mild Rotavirus-associated hepatitis (< 150 IU/L).
The present study indicated that the mean value of ALT was higher among hospitalized cases in comparison with the non-hospitalized cases (32.65±14.395 vs. 26.17 ±11.351, respectively) (P value=0.006). Moreover, the mean value of AST was higher among hospitalized cases in comparison with the non-hospitalized cases (49.45 ±28.114 vs. 34.96±17.475, respectively) (P value=0.006).
The present study indicated the presence of a significant association between the severity of the disease as determined by the Vesikari score and Rotavirus infection. There was a positive correlation between Rotavirus infection and each of hospitalization (P value<0.042), prognosis (P value<0.01), vomiting (P value<0.01), ALT (P value<0.001), and AST (P value<0.0001). In other words, cases with rotavirus infection were suffering from more severe illness than rotavirus negative cases.