A STUDY TO ASSESS THE CLINICAL AND BIOCHEMICAL PROFILE OF PATIENTS DIAGNOSED WITH HEPATITIS E IN A LARGE TEACHING HOSPITAL OF SOUTHERN INDIA
Abstract
ABSTRACT
Objective: Hepatitis E has been identified as a major health problem in developing countries and recently developed countries. To study the profile of
patients diagnosed with hepatitis E infection in a tertiary care hospital in south India.
Methods: A cross-sectional record-based study with the records of patients diagnosed with hepatitis E infection over a 40-month period from a
teaching hospital in southern India and fulfilling the following criteria was performed.
Results: The cases were predominant in the age group of 21-30 years with relative sparing of children. No seasonal variation in the occurrence or
secondary cases was observed. Temporary derangement of liver function tests was recorded in all cases. The study showed a male preponderance. As
documented in previous studies, the disease proved fatal in a primigravida who developed fulminant hepatic failure. Another interesting feature was
the presence of leptospirosis, scrub typhus, and hepatitis A as co-infection with hepatitis E.
Conclusion: In India, the awareness of the disease is also low, therefore, the diagnosis is usually not made in the majority of cases. Hence, the
availability of data regarding the clinical pattern of presentation and biochemical profile is restricted. However, there are some questions still
unanswered like the preference of the virus to infect individuals in the age group of 20-40 years, sparing of children, and increased rate of infection
among the males. The cause of the increased morbidity and mortality of this virus in pregnant women is still not known. A larger sample size and the
data on the seroprevalence of this disease in the population under study are necessary for a meaningful interpretation of its epidemiological pattern.
Keywords: Alanine transaminase, Alkaline phosphatase, Aspartate aminotransferase, Bilirubin, Liver.
Downloads
References
REFERENCES
Teshale EH, Hu DJ, Holmberg SD. The two faces of hepatitis E virus.
Clin Infect Dis 2010;51(3):328-34.
Hepatitis E FAQs for Health Professionals. Available from: http://www.
cdc.gov/hepatitis/HEV/HEVfaq.htm. [Last accessed on 2013 Jan 16].
Favorov MO, Fields HA, Purdy MA, Yashina TL, Aleksandrov AG,
Alter MJ, et al. Serologic identification of hepatitis E virus infections
in epidemic and endemic settings. J Med Virol 1992;36(4):246-50.
Chadha MS, Walimbe AM, Arankalle VA. Retrospective serological
analysis of hepatitis E patients: A long-term follow-up study. J Viral
Hepat 1999;6(6):457-61.
Abraham P. Viral hepatitis in India. Clin Lab Med 2012;32(2):159-74.
Khuroo MS. Discovery of hepatitis E: The epidemic non-A, non-B
hepatitis 30 years down the memory lane. Virus Res 2011;161(1):3-14.
Schwartz E, Jenks NP, Van Damme P, Galun E. Hepatitis E virus
infection in travelers. Clin Infect Dis 1999;29(5):1312-4.
Khuroo MS, Kamilib S, Khurooc MS, Ashgara HA. Hepatitis E virus.
Hepatology A Practical Approach. New York: Elsevier; 2004. p. 111-20.
Naik SR, Aggarwal R, Salunke PN, Mehrotra NN. A large waterborne
viral hepatitis E epidemic in Kanpur, India. Bull World Health Organ
;70(5):597-604.
Khuroo MS. Study of an epidemic of non-A, non-B hepatitis. Possibility
of another human hepatitis virus distinct from post-transfusion non-A,
non-B type. Am J Med 1980;68(6):818-24.
Vivek R, Nihal L, Illiayaraja J, Reddy PK, Sarkar R, Eapen CE, et al.
Investigation of an epidemic of Hepatitis E in Nellore in south India.
Trop Med Int Health 2010;15(11):1333-9.
Sailaja B, Murhekar MV, Hutin YJ, Kuruva S, Murthy SP, Reddy KS,
et al. Outbreak of waterborne hepatitis E in Hyderabad, India, 2005.
Epidemiol Infect 2009;137(2):234-40.
Aggarwal R, Naik SR. Hepatitis E: Intrafamilial transmission versus
waterborne spread. J Hepatol 1994;21(5):718-23.
Khuroo MS, Teli MR, Skidmore S, Sofi MA, Khuroo MI. Incidence and
severity of viral hepatitis in pregnancy. Am J Med 1981;70(2):252-5.
Bhatia V, Singhal A, Panda SK, Acharya SK. A 20-year single-center
experience with acute liver failure during pregnancy: Is the prognosis
really worse? Hepatology 2008;48(5):1577-85.
Aggarwal R. Clinical presentation of hepatitis E. Virus Res
;161(1):15-22.
Pal R, Aggarwal R, Naik SR, Das V, Das S, Naik S. Immunological
alterations in pregnant women with acute hepatitis E. J Gastroenterol
Hepatol 2005;20(7):1094-101.
Bose PD, Das BC, Kumar A, Gondal R, Kumar D, Kar P. High viral
load and deregulation of the progesterone receptor signaling pathway:
Association with hepatitis E-related poor pregnancy outcome. J Hepatol
;54(6):1107-13.
Navaneethan U, Al Mohajer M, Shata MT. Hepatitis E and pregnancy:
Understanding the pathogenesis. Liver Int 2008;28(9):1190-9.
Asian J Pharm Clin Res, Vol 9, Issue 2, 2016, 84-89
Chakrabarti et al.
Kar P, Jilani N, Husain SA, Pasha ST, Anand R, Rai A, et al. Does
hepatitis E viral load and genotypes influence the final outcome
of acute liver failure during pregnancy? Am J Gastroenterol
;103(10):2495-501.
Khuroo MS, Kamili S, Khuroo MS. Clinical course and duration of
viremia in vertically transmitted hepatitis E virus (HEV) infection in
babies born to HEV-infected mothers. J Viral Hepat 2009;16(7):519-23.
Begum N, Polipalli SK, Husain SA, Kumar A, Kar P. Duration
of hepatitis E viremia in pregnancy. Int J Gynaecol Obstet
;108(3):207-10.
Kane MA, Bradley DW, Shrestha SM, Maynard JE, Cook EH,
Mishra RP, et al. Epidemic non-A, non-B hepatitis in Nepal. Recovery
of a possible etiologic agent and transmission studies in marmosets.
JAMA 1984;252(22):3140-5.
Smego RA Jr, Khaliq AA. Epidemic non-A non-B hepatitis in urban
Karachi, Pakistan. Am J Trop Med Hyg 1988;38(3):628-32.
Malik IA, Qureshi MS, Luqman M, Qamar MA, Ahmed A, Legters LJ,
et al. Epidemics of non-A, non-B hepatitis in Pakistan. Trop Doct
;18(3):99-101.
Goldsmith R, Yarbough PO, Reyes GR, Fry KE, Gabor KA,
Kamel M, et al. Enzyme-linked immunosorbent assay for
diagnosis of acute sporadic hepatitis E in Egyptian children. Lancet
;339(8789):328-31.
Hyams KC, Purdy MA, Kaur M, McCarthy MC, Hussain MA,
el-Tigani A, et al. Acute sporadic hepatitis E in Sudanese
children: Analysis based on a new western blot assay. J Infect Dis
;165(6):1001-5.
Mushahwar IK, Dawson GJ, Bile KM, Magnius LO. Serological studies
of an enterically transmitted non-A, non-B hepatitis in Somalia. J Med
Virol 1993;40(3):218-21.
Labrique AB, Thomas DL, Stoszek SK, Nelson KE. Hepatitis E: An
emerging infectious disease. Epidemiol Rev 1999;21(2):162-79.
Published
How to Cite
Issue
Section
The publication is licensed under CC By and is open access. Copyright is with author and allowed to retain publishing rights without restrictions.