Two hundred and fifty-three cases of acute viral hepatitis admitted to Ibn Al-Khateeb Infectious Disease Hospital, Baghdad, were studied prospectively regarding the viral aetiological agent. The most common cause was infection with one of the non-A, non-B viruses (51%). The second most common cause was infection with the hepatitis B virus (32%); two of these patients had hepatitis delta-co-infection. Hepatitis A virus was responsible for 15% of the cases, and hepatitis delta-virus superinfection in 2% of the cases.

Acute viral hepatitis occupies an important place among infectious diseases in the Baghdad area and was responsible for 11.2% of the total admissions to Hummayat Infectious Diseases Hospital, Baghdad, over the five-year period 1979 to 1983. There was no change in the admission rate during this five-year period, while there was a regular and significant increase during the last six months of each year. The total number of males admitted was higher than females (P <0.01), while the fatality rate was higher in females and mainly related to the 15+ years age group (P <0.001). The total fatality rate was 6%, while the fatality rate among the fulminant cases was 84%. Of the 500 patients tested for HBsAg, 24% were positive.

Of 253 prospectively studied cases of acute viral hepatitis (AVH), 47 were fulminant (18.6%). There were 15 males and 32 females. Their age ranged from 7 to 60 years (mean, 28 years). Serological evidence of AVH-A was found in one case (2%), AVH-B in 13 cases (28%), AVH-D in one case (2%), and AVH-NANB in 32 cases (68%). Fulminant hepatitis was found in 2.6% of AVH-A cases, in 16.25% of AVH-B cases, in one of two AVH-D superinfections, and in 24.8% of the AVH-non-A, non-B (NANB) cases. The clinical picture in the two main etiological categories, namely the AVH-B and the AVH-NANB, showed that the latter possessed a more prolonged and severe clinical course with higher mortality (P <0.001). It also showed a higher mortality in females of the child bearing age, compared with males of the same age group (P <0.001).