title: MORBIDITY AND MORTALITY ASSESSMENT IN ACUTE HEPATITIS-E.
abstract: BACKGROUND
  Hepatitis-E is an enterically transmitted virus causing acute hepatitis. Mostly it is a self-limiting clinical course, but can be life threatening in certain high risk groups. Pakistan is endemic for Hepatitis-E with limited published literature. The aim of this study is to evaluate the predictors of mortality in patients with acute Hepatitis-E.
  
  
  METHODS
  We analyzed the medical records of 369 adult patients with Hepatitis-E infection admitted at Aga khan University Hospital, from January 1996 to December 2010. Details of their laboratory investigations, clinical course and complications such as FHF and mortality were noted. The outcome was compared, and determinants of mortality were evaluated in important patient subgroups.
  
  
  RESULTS
  Out of 369 patients with Hepatitis-E, 326 (88.3%) were discharged after full recovery. Out of these 22 (6%) patients had chronic liver disease CLD in this study, of whom 10 (2.7%) expired (p-value <0.001). There were about 67 (18%) pregnant patients, with a mean gestational age of 29.19 +/- 7.68 weeks and 5 (1.4%) pregnant patients died (p-value=0.23). A total of 58 (15.7%) patients were coinfected with other hepatotropic virus, and a comparison did not find an increased risk of mortality in this group.
  
  
  CONCLUSIONS
  This study showed that Hepatitis-E is significantly associated with mortality in patients suffering from pre-existing chronic liver disease. Pregnancy was not a determinant of mortality in Hepatitis-E patients in this study, and neither was coinfection with other Hepatotropic viruses.
authors.forename: Lubna
authors.initials: L
authors.lastname: Kamani
authors.forename: Saeed Sadiq
authors.initials: SS
authors.lastname: Hamid
authors.forename: Faisal Wasim
authors.initials: FW
authors.lastname: Ismail
authors.forename: Syed Waqas
authors.initials: SW
authors.lastname: Haider
authors.forename: Safia
authors.initials: S
authors.lastname: Awan
authors.forename: Ashfaq
authors.initials: A
authors.lastname: Ahmed
authors.forename: Wasim
authors.initials: W
authors.lastname: Jafri
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006508:Hepatitis Antibodies / Q000032:analysis; D016751:Hepatitis E / Q000453:epidemiology* / Q000821:virology; D016752:Hepatitis E virus / Q000276:immunology; D006801:Humans; D009017:Morbidity / Q000639:trends; D010154:Pakistan / Q000453:epidemiology; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D015996:Survival Rate / Q000639:trends; D055815:Young Adult
chemical_list: D006508:Hepatitis Antibodies