Fulminant viral hepatitis: Indian experience.

Area of Science:

• Hepatology
• Virology
• Infectious Diseases

Background:

• Fulminant viral hepatitis presents a critical diagnostic and prognostic challenge.
• Etiological identification is crucial for understanding disease progression and patient outcomes.

Purpose of the Study:

• To investigate the etiological agents of fulminant viral hepatitis in a cohort of 36 patients.
• To compare the clinical presentation and survival rates among different viral hepatitis etiologies.

Main Methods:

• Enzyme immunoassay was employed to detect Hepatitis B surface antigen (HBsAg), IgM anti-hepatitis B core (anti-HBc), and IgM anti-hepatitis A virus (anti-HAV).
• Etiological agents were classified as Hepatitis A virus (HAV), Hepatitis B virus (HBV), or non-A, non-B virus.
• Clinical features, including fever and time to encephalopathy, were recorded and analyzed.

Main Results:

• Non-A, non-B virus was the predominant cause (61.1%), followed by HBV (30.6%) and HAV (8.3%).
• IgM anti-HBc confirmed HBV in HBsAg-negative cases and suggested superinfection in an HBsAg-positive case.
• Survival rates were significantly higher in the HAV group (66.6%) compared to non-A, non-B (31.2%) and HBV (27.3%) groups (P < 0.01).
• Fever at onset was most frequent in HAV (100%), followed by HBV (54.5%) and non-A, non-B (38.88%) (P < 0.01).

Conclusions:

• Non-A, non-B viruses and HBV are significant etiological agents in fulminant viral hepatitis.
• Hepatitis A virus infection is associated with a better prognosis and distinct clinical presentation.
• Accurate etiological diagnosis using serological markers is vital for managing fulminant hepatitis.