Hepatitis-E: Clinical profile and outcome assessment from India

2021 ◽  
Vol 11 (2) ◽  
pp. 139-141
Author(s):  
Venu H Aradya ◽  
Keyword(s):  
Liver Disease ◽  
Liver Failure ◽  
Viral Hepatitis ◽  
Acute Viral Hepatitis ◽  
Tertiary Care ◽  
Hepatitis E ◽  
Chronic Liver ◽  
Enzyme Linked Immunosorbent Assay ◽  
Care Hospital ◽  
Study Results

Background: Hepatitis E is the most common cause of acute viral hepatitis in the adult population in India. Hepatitis-E has self-limiting clinical course, but can be life threatening in certain high risk groups like pregnancy and alcoholic liver disease. . The present study evaluated the predictors of mortality in patients with acute Hepatitis-E cases at a tertiary care center from India. Methods: This cross sectional study including cases of viral Hepatitis E was done at tertiary care hospital at Mysore during January 2016 to November 2016. A total of seventy nine patients diagnosed with HEV infection using IgM anti-HEV enzyme-linked immunosorbent assay (ELISA) kits were included in the study. Results: Out of seventy nine, forty two (53.2%) patients were males and thirty seven (46.8%) were females. The mean age of our study group was 44.3±13.47 years. Out of seventy nine Hepatitis E patients, six had coinfection, two with Hepatitis A (2.5%) and four (5.1%) were HBsAg positive. A total of seventy three (92.4%) patients survived while six (7.6%) patients expired during the course of the illness. Among six fatal cases, four (66.7%) died of acute on chronic liver failure and two (33.6%) died of acute liver failure (ALF). Conclusion: Pre-existing chronic liver disease was found to be significantly associated with mortality in patients suffering from viral Hepatitis E. Increased bilirubin, Low serum albumin, alcohol use, were also associated with increased mortality due to acute viral hepatitis E. Pregnancy was not a determinant of mortality in Hepatitis-E patients in this study.

scholarly journals Seroprevalence of Enterically Transmitted Hepatitis Viruses in Patients Attending a Tertiary Care Hospital in Maharashtra, India

2021 ◽  
Vol 10 (30) ◽  
pp. 2310-2313
Author(s):  
Suvarna Vaibhav Sande
Keyword(s):  
Acute Hepatitis ◽  
Viral Hepatitis ◽  
Predictive Value ◽  
Hepatitis A ◽  
Acute Viral Hepatitis ◽  
Tertiary Care ◽  
Hepatitis E ◽  
Care Hospital ◽  
Serum Samples ◽  
Hepatitis Viruses

BACKGROUND Hepatitis A & E viruses are enterically transmitted viruses responsible for acute viral hepatitis in developing countries. Hepatitis A virus (HAV) has worldwide distribution while hepatitis E virus (HEV) is restricted to tropical countries. HAV affects infants and young children while HEV affects older children and young adults. This study was conducted to determine the seroprevalence of HAV and HEV and their co-infection in patients presenting with acute viral hepatitis (AVH). METHODS 200 sera of patients suffering from suspected acute viral hepatitis (AVH) attending tertiary care rural hospital JNMC Sawangi, Wardha were included in the study. Serum samples were tested for IgM anti HAV and IgM anti - HEV for the detection of acute hepatitis A and acute hepatitis E using commercially available ELISA kit & Immunochromatography test (ICT) for comparison of ELISA and ICT. RESULTS The overall seroprevalence of HAV and HEV infection was found to be 19 %. The seroprevalence of HAV infection was found to be 13 %, HEV infection 5 % and HAV - HEV co - infection 1 %. HAV infection in males and females was found to be 16.07 % and 9.09 % respectively & HEV infection was found to be 5.35 % and 4.54 % respectively. In case of detection of HAV IgM, two serum samples were negative by ICT but positive by ELISA & for HEV IgM, one serum sample was negative by ICT but positive by ELISA. The sensitivity, specificity, positive predictive value and negative predictive value of HAV IgM was found to be 96 %, 98.8 %, 92.30 % & 99.43 % and for HEV IgM was found to be 90 %, 99.47 %, 90 % & 99.47 % respectively. CONCLUSIONS It is evident from this study that infection with enteric hepatitis viruses is not infrequent. Findings from this study emphasize the need to establish regular seroepidemiological surveys to keep track of epidemiology of these viruses. Results from rapid tests are comparable to ELISA with additional advantage of ease of interpretation and neither time consuming nor requiring special instruments. KEY WORDS Hepatitis A, Hepatitis E, Seroprevalence

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

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.

scholarly journals A study of Acute Liver Failure in adults in a tertiary care hospital

2019 ◽  
Vol 5 (6) ◽  
pp. 204-207
Author(s):  
Dr. Mohini Singh ◽  
◽  
Dr. Srilakshmi Sathiyaseelan ◽  
Devarasetty Shashank ◽  
Dr. S.R. Ramakrishnan ◽  
...  
Keyword(s):  
Liver Function ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Viral Hepatitis ◽  
Tertiary Care Hospital ◽  
Early Recognition ◽  
Tertiary Care ◽  
Care Hospital ◽  
Arterial Blood ◽  
Function Test

Acute liver failure (ALF) is a condition with rapid deterioration of liver function resulting in hepatic encephalopathy and/or coagulopathy in patients with previously normal liver. Acute liver failure (ALF) is an uncommon condition associated with high morbidity and mortality. The prognosis is poor for untreated cases of Acute liver failure, so early recognition and management of patients with acute liver failure is crucial. A cause for acute liver failure can be identified in 60 to 80 percent of patients. Identifying the underlying cause of the liver failure is important because it influences the approach to management and provides prognostic information. Aims and Objectives: The aim of our study is to identify the clinical features, etiology and outcome of acute liver failure in a tertiary care hospital. Materials and Methods: This study is an observational study where patients with Acute Liver Failure admitted in ICU in our institution after meeting the diagnostic criteria for Acute liver failure were included in the study. Details of history, relevant symptoms and baseline investigations included, complete blood count, blood glucose, renal function test, serum electrolytes, liver function test (LFT), prothrombin time, international normalized ratio (INR), lactate dehydrogenase (LDH), creatine kinase (CK)], arterial blood gas analysis, arterial lactate, arterial ammonia, amylase and lipase level and pregnancy test (if female) and ultrasonography (USG) abdomen were recorded, MRI brain and other investigations relevant to the admission diagnosis, co morbidities and aetiology if needed were recorded. All the patients received standard supportive treatment for ALF. Results: In this study of 57 patients, majority of the patients were from the age group 41 to 50 years (17 patients) and 31 to 40 years (13 patients). 36 patients were male and 21 patients were females. Jaundice and encephalopathy was observed in all 57 (100%) patients, 24 (42%) patients had INR >2.5, 27 (47%) patients had serum creatinine >1.2 mg/dl and 18 (31.5%) patients had serum ammonia levels >100 micromol/L. The lowest value for serum aminotranferase was observed in infections (other than viral hepatitis) and maximum value was observed in drugs leading to ALF.In 20 (35%) patients viral hepatitis was the cause for ALD, followed by drugs and toxins which was the cause of ALD in 18 (31.5%) patients. Infections other viral hepatitis as the aetiology for ALF was observed in 16 (28%) of patients. Ischemic hepatitis was observed in 1 and Wilson’s disease was noted in 2 patients. Total 6 (10.5%) patients out of 57 patients had died, 4 patients with hepatitis B infection, 1 patient with paracetamol over dosage and 1 patient with dengue fever had died. Conclusion: Viral hepatitis and drugs are the commonest cause for acute liver failure. The aetiology of ALF varies significantly worldwide. Determining the etiology of acute liver failure requires a combination of detailed history taking and investigations. A broad evaluation is required to identify a cause of the acute liver failure, as the prognosis is poor in untreated cases of acute liver failure, so early recognition and management of patients with acute liver failure is crucial.

scholarly journals Role of Hepatitis E Virus Infection in Acute-on-Chronic Liver Failure

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Mario Frias ◽  
Pedro López-López ◽  
Antonio Rivero ◽  
Antonio Rivero-Juarez
Keyword(s):  
Liver Disease ◽  
Liver Failure ◽  
Hepatitis E Virus ◽  
Hepatitis E ◽  
Chronic Liver ◽  
Chronic Liver Failure ◽  
Hepatic Decompensation ◽  
End Stage ◽  
The Impact

Chronic liver disease (CLD) with a variety of causes is currently reported to be one of the main causes of death worldwide. Patients with CLD experience deteriorating liver function and fibrosis, progressing to cirrhosis, chronic hepatic decompensation (CHD), end-stage liver disease (ESLD), and death. Patients may develop acute-on-chronic liver failure (ACLF), typically related to a precipitating event and associated with increased mortality. The objective of this review was to analyze the role of acute hepatitis E virus (HEV) infection in patients with CLD, focusing on the impact of this infection on patient survival and prognosis in several world regions.

scholarly journals An audit of indoor morbidity and mortality in a medical ward at a Tertiary Care Hospital

2016 ◽  
Vol 11 (1) ◽  
Author(s):  
Abeer Qadir ◽  
Muhammad Arif Nadeem ◽  
Atif Munir ◽  
Zafar Ullah Khan
Keyword(s):  
Heart Disease ◽  
Liver Disease ◽  
Ischemic Heart Disease ◽  
Chronic Liver Disease ◽  
Tertiary Care ◽  
Chronic Liver ◽  
Ischemic Heart ◽  
Care Hospital ◽  
Cerebrovascular Accidents ◽  
Number Of Patients

There is a great geographical variation in disease burden around the world, which is due primarily to environmental, genetic, social and economic factors. Similar variations exist in worldwide mortality figures from a particular disease that can be attributed almost entirely to the access and efficacy of healthcare facilities. We did this audit to identify the major causes of morbidity and mortality in patients admitted in a medical unit of a tertiary care hospital and to highlight the importance of primary prevention. The audit was carried out in West Medical Ward Mayo Hospital Lahore, Pakistan from 1st January 2004 to 31st December 2004. All patients admitted with medical problems from the Outpatient and Emergency Departments were included. During the year 2004, a total of 2045 patients were admitted, out of which maximum number of patients admitted in the ward were suffering from chronic liver disease (17%) followed by ischemic heart disease (14.4%) cerebrovascular accidents (10.4%) and renal diseases. Total number of deaths were 321 with male mortality was 167 (14.40%) and female mortality 154 (17.40%). Chronic liver disease also had the highest mortality (16.8%) followed by cerebrovascular accidents (14%), renal disease (11.5%) and ischemic heart disease (7.8%). Even the mortality due to chronic liver disease was significantly higher (p <0.01) than ischernic heart disease. The number of patients having the four common diseases having age 45 years or more (770) was significantly greater (p <0.0001) then the number of patients (279) in the age range of 15 to 44 years. It was observed that significantly greater number of male patients (595) had morbidity than females (462), (p <0.0001), while mortality has no difference. Chronic liver disease, ischemic heart disease and cerebrovascular accidents are the diseases putting maximum burden on our health resources and disabling our productive population. This audit highlights the fact that all these three groups of diseases can be prevented and thus obviates the need of primary prevention of these major killers.

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