Etiology of sporadic acute and fulminant non-A, non-B viral hepatitis in north India.
BACKGROUND
Viral hepatitis is a major public health problem in India.


OBJECTIVE
To investigate the association of various hepatitis viruses in patients with acute liver diseases in north India.


METHODS
One hundred and thirteen patients with acute viral hepatitis (AVH; n = 70) or fulminant hepatic failure (FHF; N = 43) were evaluated for the presence of hepatitis A, B, C and E virus infection. Hepatitis C virus (HCV) testing was done using second-generation anti-HCV ELISA test and reverse transcriptase polymerase chain reaction (PCR) for the detection of HCV RNA in the serum of patients with non-A, non-B (NANB) hepatitis. Detection of IgM anti-HEV antibody was done in patients found negative for the above viruses (n = 53).


RESULTS
Hepatitis A and B viruses accounted for 3.5% and 42.5% of the 113 cases, respectively. HCV infection accounted for 12% of the NANB cases with AVH and 15.5% with FHF. PCR was more useful than serological tests for the detection of HCV infection. HEV infection accounted for 49% of the NANB, non-C cases with AVH and 25% with FHF; pregnant women with HEV infection had a fulminant course. No etiological agent could be established in 28.3% of cases.


CONCLUSIONS
HEV is the most important cause of NANB hepatitis; hepatitis B virus is still a major concern, while HCV is not an important cause of acute viral liver disease in India.
Kar
P
P
Department of Medicine, Maulana Azad Medical College, New Delhi.
Budhiraja
S
S
Narang
A
A
Chakravarthy
A
A
D000208:Acute Disease; D000328:Adult; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006501:Hepatic Encephalopathy / Q000453:epidemiology / Q000821:virology*; D006526:Hepatitis C / Q000453:epidemiology*; D016751:Hepatitis E / Q000453:epidemiology*; D006525:Hepatitis, Viral, Human / Q000453:epidemiology / Q000821:virology*; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D016133:Polymerase Chain Reaction; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology / Q000821:virology