Kar P, Budhiraja S, Narang A, Chakravarthy A
Department of Medicine, Maulana Azad Medical College, New Delhi.
Indian J Gastroenterol. 1997 Apr;16(2):43-5.
Viral hepatitis is a major public health problem in India.
To investigate the association of various hepatitis viruses in patients with acute liver diseases in north India.
One hundred and thirteen patients with acute viral hepatitis (AVH; n = 70) or fulminant hepatic failure (FHF; N = 43) were evaluated for the presence of hepatitis A, B, C and E virus infection. Hepatitis C virus (HCV) testing was done using second-generation anti-HCV ELISA test and reverse transcriptase polymerase chain reaction (PCR) for the detection of HCV RNA in the serum of patients with non-A, non-B (NANB) hepatitis. Detection of IgM anti-HEV antibody was done in patients found negative for the above viruses (n = 53).
Hepatitis A and B viruses accounted for 3.5% and 42.5% of the 113 cases, respectively. HCV infection accounted for 12% of the NANB cases with AVH and 15.5% with FHF. PCR was more useful than serological tests for the detection of HCV infection. HEV infection accounted for 49% of the NANB, non-C cases with AVH and 25% with FHF; pregnant women with HEV infection had a fulminant course. No etiological agent could be established in 28.3% of cases.
HEV is the most important cause of NANB hepatitis; hepatitis B virus is still a major concern, while HCV is not an important cause of acute viral liver disease in India.
病毒性肝炎是印度的一个主要公共卫生问题。
调查印度北部急性肝病患者中各种肝炎病毒的关联。
对113例急性病毒性肝炎（AVH；n = 70）或暴发性肝衰竭（FHF；N = 43）患者进行甲型、乙型、丙型和戊型肝炎病毒感染情况评估。丙型肝炎病毒（HCV）检测采用第二代抗HCV ELISA试验，并通过逆转录聚合酶链反应（PCR）检测非甲非乙型（NANB）肝炎患者血清中的HCV RNA。对上述病毒检测呈阴性的患者（n = 53）检测IgM抗戊型肝炎病毒抗体。
甲型和乙型肝炎病毒分别占113例病例的3.5%和42.5%。HCV感染在AVH的NANB病例中占12%，在FHF病例中占15.5%。PCR在检测HCV感染方面比血清学检测更有用。戊型肝炎病毒感染在AVH的NANB、非丙型病例中占49%，在FHF病例中占25%；感染戊型肝炎病毒的孕妇病情呈暴发性。28.3%的病例无法确定病原体。
戊型肝炎病毒是NANB肝炎的最重要病因；乙型肝炎病毒仍然是一个主要问题，而在印度，丙型肝炎病毒不是急性病毒性肝病的重要病因。
