Contribution of hepatitis viral markers in clinical cases of jaundice at a tertiary care centre

Author: 
Monika Rajani

Introduction Acute viral hepatitis is caused by a group of five hepatotropic viruses namely types A, B, C, D and E. These hepatotropic viruses are serious public health concern. This study was conducted to study differential prevalence of these hepatitis viruses in different age groups.

Methodology A prospective study was conducted over a period of one year. Subjects were divided into study (n=800) and control (n=200) arm. Inclusion and exclusion criteria were defined and subjects were distributed age and sex wise. All the samples in study and control group were tested for IgM anti HAV, HBsAg, IgM Anti HCV and IgM anti HEV. Statistical Package for Social Sciences (SPSS), version 10.0 was used for statistical analysis.

Results The overall seroprevalence of acute viral hepatitis in study arm was 21.3% as compared to 8.5% in control arm. 0-10 year age group of the study arm had cumulative positivity of 25.7% with highest seropositivity for IgM anti HAV (65.4%). In 11-20 yrs of age group out of the total positive cases (23.6%), IgM anti HCV accounted for majority of cases (38.5%).For 21-30 and 31-40 years of age, the maximum contribution was by HEV i.e. 36.9% and 50% respectively. This was followed by HBV in both age groups (26.4% and 25%) respectively. In >40 yrs of age group, HBsAg was positive in 50% of the cases and IgM anti HCV was positive in another 50%.

Conclusions HAV is still the predominant infection of childhood in developing countries but age of acquisition is gradually shifting towards adolescence. HCV mainly contributes to infection in young adults but most cases are asymptomatic and hence underreported. HEV and HBV mainly contribute to infections in adults due to continued risk of exposure with age. Vaccination programs need to be consolidated for HBV and HAV.

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