Frequency and clinical course of hepatitis E in tertiary care hospitals

To find out the frequency of hepatitis E virus as a cause of acute hepatitis and its clinical course in hospitalized patients.

Cross-sectional hospital-based study.

The study was conducted in two tertiary care teaching hospitals i.e., Khyber Teaching Hospital and PGMI Lady Reading Hospital, Peshawar (Pakistan) from January to December 2002.

Amongst the total number of 1922 admitted patients, 148 had history of nausea, vomiting and jaundice and raised serum bilirubin with raised hepatic transaminases (ALT), were screened for HBV (hepatitis B virus), HCV (hepatitis C virus) and subsequently for HEV (hepatitis E virus). Acute hepatitis A, autoimmune hepatitis and Wilson's disease were excluded by doing appropriate test as and when required. The patients with hepatitis E were then monitored by checking their serial transaminases on day 1,4,8 and day 18 or until their transaminases dropped to normal. They were also clinically assessed and followed-up.

Amongst the total admission of 1922 patients during one year period, 148 had acute hepatitis and out of these, 21 patients (14.189%) suffered from hepatitis E. Seventeen patients were below the age of 40. There were increased number of cases during the late summer and early winter seasons. Majority of the hepatitis E patients recovered during the short follow-up period of two weeks. Two patients had fulminant hepatitis. A four months pregnant young female died of her illness despite intensive treatment.

Hepatitis E virus is fairly common cause of acute hepatitis in hospitalized patients. Most of the patients are having a benign self-limiting illness.