Role of hepatitis E and other hepatotropic virus in aetiology of sporadic acute viral hepatitis: A hospital based study from urban Delhi

Major hepatotropic virus continues to be an important cause of acute viral hepatitis (AVH) in developing countries like India. While epidemics of AVH have been well studied few serious sporadic cases from developing countries have been reviewed. We studied prospectively 75 cases of sporadic AVH who reported to our hospital and were evaluated for the presence of various hep atotropic viruses. The seroprevalence of IgG anti-HEV antibodies was studie d in the general population as a control. We found 53.3% (40/75) of sporadi c AVH cases were due to hepatitis E virus while 11% (8/75) were due to hepa titis B virus. Hepatitis C virus was responsible for 8% (6/75) of the spora dic AVH cases and hepatitis A was found in 5% (4/75) of the cases. No causa tive agent was found in 23% (17/75) of the sporadic AVH cases. The sporadic AVH cases due to HEV were not clinically or biochemically not different fr om AVH due to other viruses. We found a high prevalence of IgG anti-HEV in 35.6% (178/500) among the general population of urban Delhi. The study sugg ested that hepatitis E was the most common cause of sporadic AVH in urban D elhi. High seroprevalence of IgG anti-HEV antibodies in the general populat ion and amongst the sporadic AVH cases suggests that it is unlikely to be p rotective antibody. IgM anti-HEV positive serology is considered diagnostic of acute hepatitis E infection in India, where hepatitis E is endemic.