title: Prevalence of hepatitis A virus, hepatitis B virus, hepatitis C virus, hepatitis D virus and hepatitis E virus as causes of acute viral hepatitis in North India: a hospital based study.
abstract: BACKGROUND
  Acute viral hepatitis (AVH) is a major public health problem and is an important cause of morbidity and mortality.
  
  
  OBJECTIVE
  The aim of the present study is to determine the prevalence of hepatitis A virus (HAV), hepatitis B virus (HBV), hepatitis C virus (HCV), hepatitis D virus (HDV) and hepatitis E virus (HEV) as causes of AVH in a tertiary care hospital of North India.
  
  
  METHODS
  Blood samples and clinical information was collected from cases of AVH referred to the Grade I viral diagnostic laboratory over a 1-year period.
  
  
  METHODS
  Samples were tested for hepatitis B surface antigen, anti-HCV total antibodies, anti-HAV immunoglobulin M (IgM) and anti-HEV IgM by the enzyme-linked immunosorbent assay. PCR for nucleic acid detection of HBV and HCV was also carried out. Those positive for HBV infection were tested for anti-HDV antibodies.
  
  
  METHODS
  Fisher's exact test was used and a P < 0.05 was considered to be statistically significant.
  
  
  RESULTS
  Of the 267 viral hepatitis cases, 62 (23.22%) patients presented as acute hepatic failure. HAV (26.96%) was identified as the most common cause of acute hepatitis followed by HEV (17.97%), HBV (16.10%) and HCV (11.98%). Co-infections with more than one virus were present in 34 cases; HAV-HEV co-infection being the most common. HEV was the most important cause of acute hepatic failure followed by co-infection with HAV and HEV. An indication towards epidemiological shift of HAV infection from children to adults with a rise in HAV prevalence was seen.
  
  
  CONCLUSIONS
  To the best of our knowledge, this is the first report indicating epidemiological shift of HAV in Uttar Pradesh.
authors.affiliation: Department of Microbiology, K.G. Medical University, Lucknow, Uttar Pradesh, India.
authors.forename: P
authors.initials: P
authors.lastname: Jain
authors.forename: S
authors.initials: S
authors.lastname: Prakash
authors.forename: S
authors.initials: S
authors.lastname: Gupta
authors.forename: K P
authors.initials: KP
authors.lastname: Singh
authors.forename: S
authors.initials: S
authors.lastname: Shrivastava
authors.forename: D D
authors.initials: DD
authors.lastname: Singh
authors.forename: J
authors.initials: J
authors.lastname: Singh
authors.forename: A
authors.initials: A
authors.lastname: Jain
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004279:DNA, Viral / Q000097:blood; D005260:Female; D017957:Hepatitis A Virus, Human; D006508:Hepatitis Antibodies / Q000097:blood; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006518:Hepatitis Viruses / Q000145:classification* / Q000302:isolation & purification*; D006525:Hepatitis, Viral, Human / Q000453:epidemiology* / Q000821:virology*; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012367:RNA, Viral / Q000097:blood; D062606:Tertiary Care Centers; D055815:Young Adult
chemical_list: D004279:DNA, Viral; D006508:Hepatitis Antibodies; D006514:Hepatitis B Surface Antigens; D012367:RNA, Viral