Serological Evaluation Of Infectious Hepatitis In Jaundiced Patients In A Tertiary Care Centre

BACKGROUNDHepatitis A and E are both transmitted by faeco-oral route and represent the most common cause of acute hepatitis in developing countries. HAV is endemic in India and most of the population is affected in early childhood. HEV accounts for 50-60% of total acute hepatitis load in India. The study was to determine the serological profile of acute viral hepatitis cases admitted or attending the outpatient department of our institution. We also assessed the validity of an algorithm based on LFT for differential diagnosis of acute viral hepatitis in jaundiced patients.MATERIALS AND METHODSSerum samples were collected from a total of 698 patients clinically diagnosed to have acute viral hepatitis and screened for IgM antibodies to HAV, HEV, HBsAg and antibodies to HCV by ELISA after obtaining informed consent. Associated LFT parameters were also subjected to analysis.RESULTSOut of 698 cases studied, HAV was found to be the most common aetiological agent (33%) followed by HEV (8.3%). Percentage of seropositivity for HBsAg, HCV and both HAV & HEV dual infection was 2.1%, 0.7% and 2% respectively. The sensitivity, specificity and positive predictive value of the algorithm in detecting acute viral hepatitis was calculated to be 92.38%, 82.4% and 78.8% respectively.CONCLUSIONThe study highlights the importance of screening for both enterically and parenterally transmitted hepatotropic viral markers in acute viral hepatitis. Since LFT is the commonest parameter tested in jaundiced individuals, in a developing country like ours, the LFT profile based algorithm will help in the rational use of ELISA kits and interpretation of results The diagnostic workup done on algorithm in the present study will help the clinician to come to a conclusion and select out the appropriate individuals for further tests.