STATUS OF HEPATITIS VIRAL MARKERS IN PATIENTS WITH ACUTE AND CHRONIC LIVER-DISEASES IN NORTHERN INDIA

The present study describes the frequency of hepatitis viral markers i n patients with uncomplicated acute viral hepatitis (AVH; n = 32) and in patients with severe liver diseases, including those with fulminant hepatic failure (FHF; n = 110), subacute hepatic failure (SAHF; n = 6 5), and chronic active hepatitis (CAH; n = 33). The results indicate t hat hepatitis A virus infection is quite rare, whereas hepatitis B vir us (HBV) and hepatitis C virus (HCV) infections are the predominant ca uses of acute and chronic liver failure in India. The incidence of HBV infection in AVH, FHF, SAHF, and CAH groups was recorded in 3.7, 19.1 , 23.1, and 69.7% of the cases, respectively. Similarly, HCV infection in these four groups was noted in 12.5, 45, 44.6, and 48.5% of the ca ses, respectively. Further analysis of HCV infection demonstrated that it was as frequent as single infection in acute cases, but more commo nly found in association with HBV infection in chronic liver failure c ases. Hepatitis D virus (HDV) infection, as indicated by the presence of IgM anti-HDV antibodies, was recorded in 7.3% of the cases with AVH , in 7.3% of the cases with FHF, in 9.2% of the cases with SAHF, and i n 6.1% of the cases with CAH. HDV was associated with HBV both as supe rinfection as well as coinfection. Interestingly, nearly 2-6% of the c ases in each group showed the presence of simultaneous HBV, HCV, and H DV infection. 83.3% of the AVH, 42.1% of the FHF, 37.0% of the SAHF, a nd 15.1% of the CAH patients had unknown viral markers. The possible e tiology in these groups will also be discussed here.