A Descriptive Study on Prevalence, Pattern and Coinfection of Hepatitis Viruses in Acute Infectious Hepatitis

Introduction: There is variability of data regarding seroprevalence and coinfection of hepatitis viruses. Our objective was to determine the magnitude, pattern and coinfection of hepatitis viruses in clinically suspected cases of acute infectious hepatitis. Methods: This descriptive study was conducted in the Department of Microbiology at Lady Hardinge Medical College, New Delhi, over a period of 1 year from January 2008 to December 2008. All the serum samples taken from subjects (n= 600 in study group and n=200 in control group) were tested for hepatitis B surface antigen (HBsAg), Immunoglobulin M (IgM) antibody against HAV, HCV & HEV using commercially available enzyme linked immunosorbent assay kit. Serum samples positive for HBs Ag were further tested for IgM capture anti hepatitis D virus (HDV) by ELISA methodology. We used SPSS Ver.10.0 (SPSS Inc. Chica go, Illinois) for the statistical analysis. The means of continuous variables among the groups were compared using the Student’s t-test while proportions were tested by Chi-square test. Results: Seroprevalence of acute viral hepatitis was 128/600 (21.3%) and 17/200 (8.5%) in study and control group respectively (p<0.05). HAV was the commonest cause 50/600 (8.3%) followed by HCV 33/600 (5.5%), HBV 24/600 (4%) and HEV 21/600 (3.5%). Coinfection rate among the study group was 11/128 (8.5%) and maximum coinfection rates were seen with HBV 8/11 (72%). 4/24 (16.6%) of the HBV infected cases were coinfected with HDV. Male predominance was seen for all the markers. Overall sex wise seropositivity in males was 81/362 (22.3%) and 47/238 (19%) in females in study group while it was 14/121 (11.5%) and 3/79 (3.7%) respectively in controls. Conclusions: Acute infectious hepatitis is a significant burden on the society. HAV is the predominant form of acute viral hepatitis. HBV, HCV and HEV were other leading causes of acute viral hepatitis. Coinfection of HBV with HDV is the commonest pattern.