ACUTE SPORADIC VIRAL-HEPATITIS IN ETHIOPIA - CAUSES, RISK-FACTORS, AND EFFECTS ON PREGNANCY

One hundred and ten consecutive cases of acute sporadic hepatitis amon g Ethiopian patients were studied to define viral causes, identify ris k factors, and analyze demographic and clinical data. IgM antibodies t o hepatitis A virus were found in nine patients (8%), and hepatitis B surface antigen and IgM antibodies to hepatitis B core antigen were fo und in 22 (20%); these findings were considered evidence of acute hepa titis A and hepatitis B, respectively. Sera from the remaining 79 pati ents were tested for antibodies to hepatitis E virus by a blocking flu orescent antibody test. Thirty-six (33%) of these patients were seropo sitive, as compared to 4 (7%) of 59 healthy control subjects; for 43 p atients (39%), the cause of the acute sporadic hepatitis was unidentif ied. Twenty-one (19%) of the patients had antibodies to hepatitis C vi rus, as determined by ELISA. Demographic, biochemical, and clinical da ta (except in regard to sequelae) were comparable for the different ty pes of infections. The study subjects included 32 pregnant women, 19 ( 59%) of whom had hepatitis E virus infection; these infections caused death in eight of the women (mostly in the third trimester) and 10 fet al complications. Thus, hepatitis E virus is a common cause of acute s poradic viral hepatitis in Ethiopian patients, and its occurrence duri ng pregnancy is associated with high maternal and fetal morbidity and mortality.