Related Experiment Videos
Aetiology and prognostic factors in hepatic failure in central India
S B Jaiswal1, D S Chitnis, M V Asolkar
1Department of Microbiology and Immunology, Choithram Hospital and Research Centre, Indore, India.
Insights
Hepatitis E virus (HEV) and hepatitis B virus (HBV) are key causes of acute liver failure in India. Risk factors include age, viral etiology, alcohol, and pregnancy, with high bilirubin and prothrombin times indicating poor prognosis.
Area of Science:
- Hepatology
- Virology
- Public Health
Background:
- Liver failure presents a significant health challenge in central India.
- Understanding the specific etiological agents and prognostic factors is crucial for effective management.
Purpose of the Study:
- To determine the causes and prognostic indicators of liver failure in central India.
- To differentiate between fulminant, subacute, and chronic hepatic failure cases.
Main Methods:
- Retrospective analysis of 122 liver failure cases.
- Serological testing for hepatitis viruses (HEV, HBV, HCV).
- Assessment of clinical and biochemical parameters for risk stratification.
Main Results:
- Hepatitis E virus (HEV) and Hepatitis B virus (HBV) were primary causes of fulminant hepatic failure (FHF).
- Pregnancy, particularly in the third trimester, was a significant risk factor for HEV-related FHF.
- Age over 40, identifiable viral etiology, male alcohol consumption, and elevated bilirubin/prothrombin levels were identified as prognostic risks.
Conclusions:
- HEV and HBV are major etiological agents of liver failure in this region.
- Specific demographic and clinical factors significantly influence patient outcomes.
- Early identification of risk factors is essential for improving survival rates in liver failure patients.
Abstract:
The present study was undertaken to establish the aetiology and prognostic factors of liver failure in central India. Of the 122 cases of hepatic failure 95 (78%), 19 (15.5%) and 8 (6.5%) were labelled as fulminant hepatic failure (FHF), chronic hepatic failure (CHF) and subacute hepatic failure (SAHF) respectively. Hepatitis E virus (HEV) and hepatitis B virus (HBV) were aetiological agents amongst 41% (n = 39) and 37% (n = 35) patients with FHF respectively. Mixed infection among such cases even though observed was infrequent and 15% (n = 14) of FHF did not have any serological markers. They were presumed to be due to non A-E viral infection. Thirty-one (33%) of the FHF patients were pregnant and 29 (94%) of them were due to HEV. Amongst patients with SAHF and CHF, HBV and HCV were important aetiological agents. The static prognostic risk factors noted in the present study are age above 40 years, presence of identifiable viral aetiology (A to E), alcoholic status in males and pregnancy particularly in the third trimester or postpartum state. Among the dynamic factors, bilirubin level above 20 mg/dl and prothrombin time over 20 seconds appeared to be the risk factors.