Etiological and clinical profile of acute hepatitis in a tertiary referral center in North India

Saigal, S.; Saraf, N.; Anand, V.; Kumar, M.; Sud, R.; Sama, S.K. and Arora, A. (2002) Etiological and clinical profile of acute hepatitis in a tertiary referral center in North India. Indian Journal of Gastroenterology, 21 (1).

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Abstract

Introduction: Hepatotropic viruses are the leading cause of acute hepatitis, however the etiological agent remains unidentified in significant proportion of patients. The present study was conducted to analyze the spectrum of acute hepatitis in adults in tertiary referral center in North India. Methods: We prospectively studied adult patients who presented with acute hepatitis. The patients underwent a detailed evaluation to establish the causative agent for acute hepatitis including the presence of various hepatitis viruses. Results: The various causes of acute hepatitis included viral hepatitis (64%, 93/145), drug induced hepatitis (10%, 15/ 145), ischemic hepatitis (2%, 3/145), & acute fatty liver of pregnancy (0.7%, 1/145). No, causative agent could be identified in 33 patients (23%). Amongst the viral hepatitis group, hepatitis E was the commonest (29%, 41/145) followed by hepatitis B (23%, 33/145) & hepatitis A (12%, 17/145). Two patients had mixed infection with hepatitis A&E (1.4%, 2/145). The mean age of the patients was similar in the different viral groups. The clinical and biomedical features of sporadic hepatitis E was not different from that of sporadic hepatitis A or hepatitis B. Cholestasis was significantly more common in the viral group as compared to the non-viral group (P<0.01). Of the 15 the patients with drug- induced hepatitis, antitubercular drugs were the most common (87%, 13/15), while 1 had valporate induced hepatotoxicity, and 1 another had history of indigenous drugs. Conclusions: Hepatitis E remains the commonest cause of sporadic acute viral hepatitis in adults in North India, whilst in the non-viral group, drug induced hepatotoxicity is the commonest.

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