Abstract

CLINICAL PROFILE OF ACUTE VIRAL HEPATITIS PATIENTS AT A TERTIARY CARE HOSPITAL IN NORTHERN INDIA- AN OBSERVATIONAL STUDY

Author(s): Rajesh Kumar Arya, Sudhir Kumar Verma, Vivek Kumar, Satyendra Kumar Sonkar, Ajay Kumar, Harish Gupta, Satish Kumar, Durga Prasad Verma

BACKGROUND Acute viral hepatitis is a common cause of acute jaundice in India. Every year, we are getting outbreaks of viral hepatitis, most commonly in rainy season, leading to significant morbidity and mortality. Therefore, it is important to carry out an observational study to know the demographic profile, aetiology, clinical features, complications and mortality of viral hepatitis patients, so that appropriate measures can be taken to rectify deficits in the management of such patients for better outcome. MATERIALS AND METHODS This study was an observational study conducted in Department of Medicine, King George’s Medical University, Lucknow, India for a period of three months in rainy season from July 2018 to September 2018. Patients’ data was analysed for age, sex, occupation, address, clinical features, complications and outcome. RESULTS 100 cases consisting of 56 males and 44 females were enrolled in the present study. The mean age of admitted patients was 33±14 years. 65 cases were from urban and 35 cases were from rural areas. Most of the patients belonged to low socioeconomic status. Common presenting complaints were nausea, vomiting, yellowish discolouration of eyes and urine, fever, fatigue, loss of appetite and upper abdominal pain. Most common signs were icterus followed by tender hepatomegaly. Virology suggested that hepatitis E was the most common virus detected followed by hepatitis A, B and C. Co-infection with hepatitis A and E was observed in 8 patients leading to higher morbidity and mortality. Hepatic encephalopathy and haematuria was observed in 20 and 6 patients respectively. All patients were managed conservatively, and most patients were discharged in satisfactory condition. In spite of our best efforts, 27 patients expired. CONCLUSION Acute viral hepatitis is a public health problem causing significant morbidity and mortality. Most of the patients had hepatitis E and A, which are transmitted through faeco-oral route. Longer duration of symptoms, deeper level of coma in hepatic encephalopathy, bleeding manifestations, higher TLC, PT, INR, urea and creatinine are associated with higher mortality rate. So, public awareness programmes to maintain hygiene, clean drinking water, use of sanitary toilets and vaccination against hepatitis B and A should be promoted by the health care professionals.