Analysis of serological evidence of different hepatitis viruses in acute viral hepatitis in prisoners in relation to risk factors

Background & objectives : The present study describes an outbreak of acute viral hepatitis in an institutional population (inmates of a prison) with a n aim to delineate the etiological agents of this outbreak and to analyse t he clinical, biochemical and serological evidence of different hepatitis vi ruses in relation to risk factors. Methods : Fifty patients of acute viral hepatitis identified during the out break were evaluated on the basis of history, clinical examination, risk fa ctor distribution, biochemical profile and serological markers for hepatiti s A-E infection. Adequate epidemiological data were collected from prison a dministration including housing of prisoners, food and water supply. Results : Of the 50 patients, 35 (70%) had serological evidence of HEV infe ction. Evidence of HBV infection was found in 17 patients (34%), HAV infect ion in 2 (4%) and HCV in 8 (16%) patients. While 16 patients (32%) had evid ence of multiple viral infections, none of the viral markers could be detec ted in 8 patients (16%). One or more risk factor(s) could be identified in more than half of the subjects (26/50; 52%). There were 11 patients who gav e history of more than one risk factor while 24 (48%) patients had none of the risk factors. Interpretation & conclusions : HEV was found to be the major cause of the o utbreak and contamination of drinking water supply could be the possible so urce of infection. This outbreak was seroepidemiologically similar to other outbreaks of hepatitis occurring in the country with HEV being the most co mmon cause. However, there was evidence of multiple viral infections, parti cularly HBV and HCV in the high-risk predisposed prison population.