Spectrum of Viral Hepatitis in Patients Attending Super Speciality Hospital from North India

Background: Viral hepatitis in acute and chronic form remains a major cause of morbidity and mortality in India. Exposure to Hepatitis A Virus (HAV),Hepatitis E virus (HEV),Hepatitis B Virus (HBV) and Hepatitis C Virus infection vary in different parts of country with different socioeconomic groups. The prevalence of HAV, HEV, HBV, and HCV infection among children up to 12 years, adolescents between 13 yrs. to 18 yrs. and adults from this region attending hospital is not known. Methods: 2892 patients (2011 Male, 881 Female) of acute and chronic liver disease with suspected viral etiology and admitted between January 2012 to July 2014 were included in the study. Clinical features of patients, routine diagnostic investigations including abdominal ultrasound were recorded. Two ml. of blood was collected, serum separated and stored at -20°C. These serum samples were tested for anti HAV IgM, anti HEV IgM, HBsAg and anti HCV by ELISA. Results: Overall 120 children (75 Male,45 Female) of acute hepatitis and acute on chronic hepatitis were reactive for anti HAV IgM (120/2892, 4.15%) and 05 children were reactive for anti HEV IgM (0.17%). 16 children (13 Male,03 Female) of chronic liver disease were HBsAg (0.55%) reactive and 07 children had HCV (0.24%) infection. Among adolescents 09 patients were reactive for anti HAV IgM (0.31%) and 04 adolescents had HEV (0.14%) infection. 05 adolescents were HBsAg (0.17%) reactive and 04 were having HCV (0.14%) infection. Among adult, 70 patients (58 Male,12 Female) were reactive for anti HAV IgM ( 2.42%), 14 patients reactive for anti HEV IgM (0.48%). 92 adult patients (73 Male, 19 Female) were HBsAg (3.18%) reactive.102 patients (82 Male, 20 Female) of chronic liver disease were reactive for anti HCV( 3.52%).Besides 22 patients (0.76%) had dual viral infections. Conclusion: 4.15% of children and 2.42% of adults were suffering from HAV infection needing hospitalization indicating high infection of HAV in adults. 0.17% children and 0.48% of adults had HEV infection.HBV infection was present in 0.55% of children and 3.18% of adult patients.0.24% of children and 3.52% of adult patients had HCV infection. Prophylactic vaccination against HAV infection is needed among children and adults from this region besides vaccination against HBV infection.