Combating the wrath of viral hepatitis in India

Satsangi, Sandeep; Dhiman, Radha K.

doi:10.4103/0971-5916.193275

Cited by 7 publications

(4 citation statements)

References 27 publications

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“…In a study dated in 2014 from Pune, it was shown that the sero-epidemiology of HAV in India was shifting, with the seroprevalence of the virus increasing from 30.3% in children between the ages of 18 months and 6 years to 50.3% underage group of 6 to 10 years. In addition, HEV epidemics are more prone to infect women in the third trimester than men and nonpregnant females [2].…”

Section: Letter To Editormentioning

confidence: 99%

Tackling the Burden of Viral Hepatitis in India: A Call for Collaborative Efforts

Beig,

Singh,

Sharma

et al. 2023

jhepatres

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Viral hepatitis is defined as a widespread infectious disease involving the inflammation of liver caused by hepatitis virus A, B, C, D and E. The majority of deaths linked to viral hepatitis are caused by HBV, HCV, and HDV, which are transmitted parenterally and induce chronic hepatitis with distant sequelae like liver cirrhosis and hepatocellular cancer [1]. According to WHO latest estimates, viral hepatitis is now acknowledged as a serious public health problem in India with over 40 million people chronically infected with HBV and six to twelve million people with HCV. In a study dated in 2014 from Pune, it was shown that the sero-epidemiology of HAV in India was shifting, with the seroprevalence of the virus increasing from 30.3% in children between the ages of 18 months and 6 years to 50.3% underage group of 6 to 10 years. In addition, HEV epidemics are more prone to infect women in the third trimester than men and non-pregnant females [2].

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Section: Letter To Editormentioning

confidence: 99%

Tackling the Burden of Viral Hepatitis in India: A Call for Collaborative Efforts

Beig,

Singh,

Sharma

et al. 2023

jhepatres

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“…Hepatitis B and C if lasting more than six months are considered chronic whereas it is three months for hepatitis E. Chronic hepatitis can eventually progress to liver cirrhosis, liver failure, and hepatocellular carcinoma [ 1 ]. Viral hepatitis is a cause for major healthcare burden in India and is now equated as a threat comparable to the “big three” communicable diseases - HIV/AIDS, malaria, and tuberculosis [ 3 ]. Viral hepatitis is caused by at least five pathogenic hepatotropic viruses: hepatitis A (HAV), B (HBV), C (HCV), D (HDV), and E (HEV) viruses.…”

Section: Introductionmentioning

confidence: 99%

“…Epidemic jaundice due to hepatitis was first described by Hippocrates [ 5 ]. The hepatitis E virus (HEV) is the most important cause of epidemic hepatitis, whereas the hepatitis A virus (HAV) is more common among children [ 3 ]. Most acute liver failures diagnosed are attributable to HEV [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Clinico-Serological Profile of Infective Causes of Acute Hepatitis in Children Admitted to a Tertiary Care Centre

Gupta¹,

Deshpande²,

Choraria³

et al. 2023

Cureus

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Background: Hepatitis is a major cause of healthcare burden in India. Hepatitis A is the most common cause of acute viral hepatitis in the pediatric population whereas hepatitis E virus (HEV) is the most important cause of epidemic hepatitis. Various other causes of acute infective hepatitis in children are dengue, malaria, and enteric fever. The aim of the present study is to understand the clinico-serological profile in cases of acute infective hepatitis in children. Methodology: The present study is a cross-sectional study that was carried out from 1 September 2017 to 31 March 2019. A total of 89 children in the age group 1-18 years with clinically suspected acute infective hepatitis and subsequent confirmation on laboratory tests were included in the study. Results: Hepatitis A (48.3%) was found to be the most common aetiology followed by dengue (22.5%) and hepatitis E (12.4%). No cases of hepatitis B or hepatitis C were found. The most common presenting complaint was fever (90%) and the most common clinical finding was icterus (69.7%). The sensitivity of icterus for the diagnosis of hepatitis was found to be 70%. Lab investigations showed a significant association between different etiologies of infective hepatitis with packed cell volume (PCV), white blood cell (WBC) count, and platelet count. Levels of aspartate aminotransferase (AST) and alanine transaminase (ALT) were raised in samples of patients with hepatitis A, hepatitis E, and combined hepatitis A and E infection as compared to other causes. All cases of hepatitis A and E were diagnosed with positive IgM antibody tests to the respective viral antigens. The most common complication was hepatic encephalopathy which was seen in patients with hepatitis A, dengue, and septicemia. Around 99% of patients recovered well and were discharged. One death occurred in a case of septicemia with septic shock with multiple organ dysfunction syndrome (MODS). Conclusion: The most common cause of infective hepatitis in children is hepatitis A. Other causes like dengue, malaria, and typhoid should also be kept in mind. The absence of icterus does not rule out hepatitis. Lab investigations including serology are important to confirm the diagnosis of various causes of hepatitis. Timely immunization against hepatitis is strongly recommended.

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“…This single-stranded non-enveloped RNA virus from the Picornaviridae family spreads via the feco-oral route and is mostly related to poor hygiene and unsanitary conditions in the community. 2 The highest incidence of hepatitis A infection has been reported in developing countries, including Africa, Central and South America, and South-East Asia. Bangladesh is considered to be highly endemic for hepatitis A infection, with 100% of children ≤ 6 years of age exposed to HAV.…”

mentioning

confidence: 99%

Atypical presentations of hepatitis A infection in children

Munmun

Yadav

Benzamin

et al. 2021

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Background Hepatitis A is the most common cause of acute viral hepatitis, with a typical simple, self-limiting course. But it is not free from complications. Atypical presentations, such as in the form of prolonged cholestasis, ascites, pleural effusion, relapsing hepatitis, or fulminant hepatic failure, pose challenges to disease management. Knowledge about varying presentations and identification of factors associated with atypical presentations will help to early diagnosis of atypical courses of disease. Objective To describe various atypical clinical presentations, biochemical findings of hepatitis A infection, and possible related factors. Methods Ninety-five children aged 1 to 18 years, diagnosed with hepatitis A infection, and admitted to the Department of Pediatric Gastroenterology & Nutrition, BSMMU, Dhaka, Bangladesh from January 2015 to May 2018 were studied retrospectively. Results Atypical presentations were manifested in 19 (20%) out of 95 children with hepatitis A virus (HAV) infection. The mean age of atypical patients [6.32 (SD 3.45) years] was significantly lower than that of typical patients [8.22 (SD 3.58) years] (P=0.0041). The most common atypical manifestation was ascites (11/19), followed by hepatic encephalopathy (9/19), acute liver failure (719), thrombocytopenia (2/19), pleural effusion (2/19), and cholestasis (1; 1.1%). Children with atypical features had significantly higher international normalized ratio (INR) and serum bilirubin, as well as lower hemoglobin level than the typical group. Children of atypical group had significantly higher number of organomegaly and coagulopathy. Conclusion Ascites, hepatic encephalopathy, acute liver failure, thrombocytopenia, pleural effusion, and prolonged cholestasis were common forms of atypical presentation. Younger age, organomegaly, higher bilirubin level, prolonged PT, and decreased hemoglobin level could be predictive of an atypical presentation of HAV in children.

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Combating the wrath of viral hepatitis in India

Cited by 7 publications

References 27 publications

Tackling the Burden of Viral Hepatitis in India: A Call for Collaborative Efforts

Tackling the Burden of Viral Hepatitis in India: A Call for Collaborative Efforts

Clinico-Serological Profile of Infective Causes of Acute Hepatitis in Children Admitted to a Tertiary Care Centre

Atypical presentations of hepatitis A infection in children

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