Etiological and Epidemiological Characteristics of Lethality from Acute Viral Hepatitis, Kyrgyzstan, 2009−2018

Abstract

Purpose. Study of the etiological structure of lethality from acute viral hepatitis and its comparison with morbidity and mortality for the period of 2009−2018.Materials and methods. State Reporting Forms No. 1 “Report on Infectious, Parasitic and Non-Infectious Diseases” for the period of 2009−2018 were studied. The data was processed by the Microsoft Office Excel statistical package.Results. In Kyrgyzstan, during the period of 2009−2018, 138,612 cases of acute viral hepatitis (AVH) were detected, of which 109 patients had fatal outcomes. In the general structure of the latter, the proportions of patients with acute hepatitis B (AHB 36.7%) and A (AHA, 35.7%) were approximately the same. In every fifth case, “unverified acute viral hepatitis (UAVH)” was diagnosed (22.9%). Acute hepatitis C (AHC) was the cause of death in 4 patients (3%), and hepatitis D virus (HDV) infection in 1 patient. Among the deceased, there were no cases of hepatitis E. Lethality from AHB was recorded in 5 children, and from hepatitis C in one child. At the same time, 9 out of 25 patients with “Unverified Acute Viral Hepatitis” were children. Over the period of 2009−2018, the incidence of AHB was 31.3 times lower than that of all AVH in general (240.9 and 7.7⁰/0000, AVH and AHB, respectively), the mortality rate was 2.7 times lower (0.19 and 0.07⁰/0000, AVH and AHB, respectively), and the lethality rate was 11.4 times higher (7.9 and 89.8⁰/0000, AVH and AHB, respectively). The average incidence of AHB in children was 6.4 times lower (7.7 and 1.2⁰/0000, total and children, respectively), the mortality rate was 2.3 times lower (0.07 and 0.03⁰/0000, total and children, respectively), and the lethality rate was 1.8 times higher (89.8 and 165.9⁰/0000, total and children, respectively).Conclusion. The existence of morbidity and lethality in adults and children from acute hepatitis indicates a high disease burden for the country. The high proportion of AHB and AHA in the structure of AVH mortality requires improving the quality of immunization of children and expanding the coverage of adults with vaccination against these viral hepatitis. The increase in lethality against the background of a tenfold decrease in the incidence of AVH points out that the number of patients who have died from this pathology does not decrease.

Clinical and Epidemiological Characteristics of the Course of Acute Viral Hepatitis B and Unverified Hepatitis in Persons Infected With the Herpes Simplex Virus

“…In 20% of patients, while taking acyclovir, a positive trend was noted: a significant decrease in intoxication, jaundice, improvement in laboratory and biochemical parameters (decrease in bilirubin and transaminase activity, normalization of the coagulogram). Timely prescribed treatment with acyclovir can lead to a favorable outcome of herpetic hepatitis, which determines the importance of improving the clinical and laboratory diagnosis of this disease [7,9]. According to the literature, the survival rate among patients treated with acyclovir is higher than in those who did not receive it (88% versus 51%) [10].…”

“…The etiology, clinical and laboratory diagnostics, treatment and prevention of viral hepatitis have not yet been sufficiently studied. The spectrum of herpes-induced liver lesions is quite wide: from asymptomatic hepatitis to fulminant forms [4,5,6,7]. For example, HSV-hepatitis is characterized by a severe course and often occurs in a fulminant form with the development of signs of acute liver failure and encephalopathy.…”

“…For example, HSV-hepatitis is characterized by a severe course and often occurs in a fulminant form with the development of signs of acute liver failure and encephalopathy. Mortality according to different authors is high and ranges from 40% to 80% [4, 5,6,7]. Therefore, despite significant progress in our knowledge of viral hepatitis, their etiology, pathogenesis, clinic, laboratory diagnostics, treatment and preven-tion, it is necessary to continue studying this urgent problem.…”