Seroprevalence of hepatitis A virus and hepatitis E virus among the patients presenting with acute viral hepatitis admitted in a tertiary care center located in Central India

Background: Hepatitis A virus (HAV) and hepatitis E virus (HEV) cause acute hepatitis in humans and are transmitted mainly through the fecal-oral route. They pose major health problems in developing countries. This study was done to determine prevalence of HAV and HEV in patients presenting with AVH and the co-infection of HAV and HEV in these patients.Methods: The study was conducted in the virology research and diagnostic laboratory, PGIMS Rohtak during the study period of August 2017-December 2018. The study population included sera of individuals from all age group who were suspected of acute viral hepatitis (AVH). All the sera were screened for IgM antibody to HEV and HAV using IgM capture ELISA.Results: HEV IgM ELISA test was performed in 307 patients (mean age 34 years;), with an overall seroprevalence rate of 138(44.9%). HAV antibodies were detected in 109 subjects, with a median age of 9.5 years the seroprevalence of HAV was 34 (31.1%). HEV seropositivity was highest in the age group 20-30 years. Mean age was 34 years whereas the interquartile range was from 14-71 years. HAV infection was positive mainly in the age group <10 years. With interquartile range from 6-16 years. Out of total 34 patients positive for HAV infection males were 20 (58.8%), whereas females were 14(41.1%). HEV IgM was positive in 138 patients, out of which male were 96 (69.56%) and females were 42 (30.43%). HEV IgM was positive in 138 patients, out of which male were 96 (69.56%) and females were 42 (30.43%). HAV and HEV seen to be prevalent all with highest predominance seen towards the end of monsoons (August and September) and beginning of winters.Conclusions: The present study also points toward HEV being the prime etiological agent for outbreaks of acute hepatitis in the studied region of Haryana (Rohtak), India. A comparatively lower HAV prevalence may be the consequence of an overall declining trend due to improved living standards and environmental hygiene.

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Study of acute viral hepatitis with special reference to fulminant hepatic failure

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20182559 ◽

2018 ◽

Vol 5 (4) ◽

pp. 1533

Author(s):

Rajesh N. Pankhaniya ◽

Yogesh N. Parikh ◽

Dhanya Soodhana Mohan

Keyword(s):

Hepatic Encephalopathy ◽

Viral Hepatitis ◽

Fulminant Hepatic Failure ◽

Hepatic Failure ◽

Hepatitis E Virus ◽

Hepatitis A ◽

Acute Viral Hepatitis ◽

Hepatitis A Virus ◽

Hepatitis E ◽

Age Group

Background: Fulminant hepatic failure is a complication of viral hepatitis and is one of the leading causes of death in hospitalized children with viral hepatitis in India.Methods: All the patients suspected to have acute viral hepatitis and/or fulminant hepatic failures with hepatic encephalopathies were included in the study and the diagnosis was made on the basis of history, clinical examination including a detailed neurological examination. Triage scoring, Glasgow coma scale, encephalopathy grading were recorded at the time of admission and necessary investigations were carried out.Results: The occurrence of acute viral hepatitis and fulminant hepatic failure was 200 (2.004%) and 40 (0.401%) respectively during study period. Highest occurrence of 35.50% in the age group of 4-6 years, yellowish discoloration of the eyes or the urine was the most common presenting complaint. Only 45 % of the children who had fulminant hepatic failure survived and mortality was found to be 100% in those children who had grade 4 hepatic encephalopathy. Mortality was higher in those children who had duration of more than 10 days between the onset of jaundice and encephalopathy. Mortality was higher in those with prothrombin time between 41 to 50 seconds and with serum ammonia level more than 200 mmol/l. Hepatitis A virus was the most common cause of fulminant hepatic failure and Hepatitis E virus with hepatic encephalopathy was associated with 100 % mortality.Conclusions: Hepatitis A infection though associated with a good prognosis, younger age group (< 6 years) and co infection with Hepatitis E virus have a poor prognosis. Good hygiene practices and early immunization could be a step towards the prevention of Hepatitis A infection.

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Co-infection of Hepatitis A and Hepatitis E Viruses among the Acute Viral Hepatitis Cases in Tertiary Care Hospital –A Four Years Retrospective Study

Journal of Pure and Applied Microbiology ◽

10.22207/jpam.14.3.45 ◽

2020 ◽

Vol 14 (3) ◽

pp. 2047-2051

Author(s):

Ravindra V. Shinde ◽

Anjali R. Shinde ◽

Anjali D. Patil ◽

S.K. Pawar ◽

S.T. Mohite ◽

...

Keyword(s):

Viral Hepatitis ◽

Hepatitis A ◽

Acute Viral Hepatitis ◽

Care Center ◽

Tertiary Care ◽

Hepatitis E ◽

Care Hospital ◽

Age Group ◽

Tertiary Care Centre ◽

Health Care Center

Acute viral hepatitis(AVH) is caused by Hepatitis A (HAV) and Hepatitis E(HEV). It is major health burden in India. Both the viruses HAV and HEV are primarily transmitted via the faeco-oral course. Study was conducted to determine the seroprevalence of HAV, HEV and rate of co-infection in AVH patients attending rural tertiary care centre. A retrospective laboratory record based study was carried out in rural tertiary health care center located in Western Maharashtra. Laboratory and Medical records of suspected acute viral infection patients were analyzed during study. Study period was June 2014 to July 2018. Commercially available ELISA kits of IgM anti-HAV and IgM anti-HEV were used to analyze serum samples of suspected study participants. Tests were carried out as per the manufacturer’s instructions. A total of 778 acute viral hepatitis cases were included in the study from July 2014 to July 2018 among which 85/778 (10.9 %) detected positive for HAV and 121/778 (15.6%) detected positive for HEV. Co-infection was identified in 6/778(0.8 %). Jaundice, fever fatigue and hepatomegaly were common clinical presentation in HAV, HEV and confection with both viruses in acute viral hepatitis patients. Study indicated low exposure to HAV in childhood bellow 16 years. Co-infection rate was detected high in 16-25 years age group. Vaccination policy against HAV in adolescent age group needed as there is change epidemiological shift of HAV which has been observed in the current study. These data will helps for planning future vaccination strategies, better implementation sanitation program, and safe water supply in this geographic area.

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