Feco-orally transmitted viral hepatitis in a tertiary care hospital in urban India

Abstract

Objective: To investigate the magnitude and pattern of hepatitis viral markers in feco-orally transmitted acute viral hepatitis with their relation to age and sex. Methods: This prospective study was carried out in two groups of subjects including the study group of 600 patients with clinically suspected infectious hepatitis and control group of 200 patients showing no clinical evidence of acute infectious hepatitis. Serum samples were tested for the presence of anti-hepatitis A virus (HAV) IgM and Anti-hepatitis E virus (HEV) IgM antibodies using commercial ELISA test kits. Results: The seroprevalence rate of feco-orally transmitted acute viral hepatitis was 11.8% in the study group compared to 4.5% in the control group (p=0.007). The prevalence of anti-HAV IgM was 8.3% while that of anti-HEV IgM was 3.5% in the same group. Maximum seropositivity of anti-HAV IgM was seen in 0-10 years of age in the study group (16.8%) followed by 11-20 years (7.2%) and 21-30 years (4.6%). In the study group, the maximum seropositivity of anti-HEV IgM was seen in 21-30 years (10.7%) followed by 31-40 years (2.9%), 11-20 years (2.7%) and 0-10 years (0.9%). Male predominance was seen in both types of acute viral hepatitis. Conclusion: While HEV infection was predominantly seen in young adults, HAV infection was predominantly a childhood infection and its prevalence decreased by age. Being enterically transmitted viral diseases it is recommended that immunization programs, public awareness measures for hygiene and safe drinking water should be consolidated.

Seroprevalence of IgM antibodies to hepatitis A virus in at-risk group in Benin City, Nigeria

“…The three anti-HAV IgM positive cases were aged between 22 and 31 years. This finding is not in agreement with that of Rajani and Jais ( 10 ), who observed anti-HAV IgM only in the age group ≤20 years. This may reflect geographic differences as well as the environmental dynamics of New Delhi and Benin City.…”

“…Three samples (1.5%) were positive for anti-HAV IgM. This is comparable to the 2.0% reported among apparently healthy individuals in India ( 10 ). This may indicate asymptomatic acute HAV infection, but molecular analysis is needed to verify this because HAV RNA is not detected in all HAV IgM positive specimens ( 12 ).…”

“…Nevertheless, as many hepatitis A cases are asymptomatic, anti-HAV IgM can be found in individuals who do not have clinical symptoms or biological abnormalities ( 9 ). Indeed, anti-HAV IgM has been detected in apparently healthy individuals in India ( 10 ). This is surprising because adults are often thought to have symptomatic infection ( 11 ).…”

Trends in seroprevalence of enteric transmitted hepatitis virus infections at a tertiary care hospital in Delhi: a 4-year review

“…Symptomatic HEV infection tends to occur more frequently in adults than in children. 5 This pattern is echoed in the study, with HEV infection significantly higher in adults (5.77%) than in children (1.4%). HEV infection is associated with diverse extrahepatic manifestations, such as glomerulonephritis, hematological disorders, and autoimmune conditions.…”