Hepatitis E is the primary cause of acute hepatitis: Study
The study analysed data from 2,488 patients from Mumbai and other parts of Maharashtra being treated at Kasturba Hospital, across three years. The researchers concluded that Hepatitis E accounted for 52.65% of acute cases, followed by Hepatitis A at 22.18%, and Hepatitis B at 10.56%. In all age categories, Hepatitis E accounted for the majority of cases.
Overall, 66.1% of the patients studied were male, with the highest incidence observed among individuals aged 18 to 30 years.
The study, published in January, was conducted by Dr Pravin Rathi and other doctors from the gastroenterology department of Nair Hospital, along with Dr Chandrakant Pawar from the infectious diseases department of Kasturba Hospital. The research focused on patients primarily from Mumbai and its outskirts, many belonging to economically weaker sections.
Hepatitis E spreads through contaminated food and water, which is why cases of acute hepatitis rise during the monsoon. These conditions, as well as unsanitary conditions including the accumulation of sewage in open spaces, facilitates its spread.
'Acute hepatitis is a major public health issue in low middle-income countries like India¸ where there is also a significant under-reporting of instances. The precise global illness burden of acute hepatitis is unknown. Even though the majority of these individuals have viral hepatitis, autoimmune hepatitis and drug-induced liver injury are on the rise as a result of urbanisation and greater knowledge of these conditions,' said the researchers.
While Hepatitis A and E spread through contaminated water and food, B, C and D spread through blood and body fluids and can cause severe complications including cirrhosis, liver cancer and liver failure.
The researchers also observed that with advancing age, the prevalence of Hepatitis A and E declined, and, on the contrary, the prevalence of hepatitis B and hepatitis C increased with age.
'Although 98% of acute hepatitis cases tend to recover, the remaining 2% are at risk of liver failure or cirrhosis, necessitating urgent liver transplant. The infection poses significant risks to pregnant women, with high mortality rates reported for both mothers and fetuses,' said Dr Rathi, head of the gastroenterology department at Nair Hospital.
He explained that Hepatitis E can cause liver inflammation, which often resolves itself. However, individuals with weakened immune systems can develop acute symptoms and are at higher risk of developing complications.
'Gastrointestinal bleeding, anemia, low serum albumin, and presentations as acute liver failure (ALF) or acute-on-chronic liver failure (ACLF) are independent predictors of mortality in acute hepatitis patients. Pruritus, an uncomfortable sensation leading to itchy skin, was observed in about 30% of patients with Hepatitis E, commonly associated with cholestasis (obstruction to the flow of bile), a consequence of the infection,' read the study.
In the study, the researchers noted a decline in Hepatitis C cases, attributing this to the availability of effective antiviral treatments. 'Consuming clean water, either by boiling or using purifiers, ensuring no cross-contamination between sewage and drinking water pipelines, and avoiding street food, especially during summer and monsoon seasons is important.
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