Frequency and clinical course of hepatitis E in tertiary care hospitals.
OBJECTIVE: To find out the frequency of hepatitis E virus as a cause of acute hepatitis and its clinical course in hospitalized patients. DESIGN: Cross-sectional hospital-based study. PLACE AND DURATION OF STUDY: The study was conducted in two tertiary care teaching hospitals i.e., Khyber Teaching Hospital and PGMI Lady Reading Hospital, Peshawar (Pakistan) from January to December 2002. PATIENTS AND METHODS: Amongst the total number of 1922 admitted patients, 148 had history of nausea, vomiting and jaundice and raised serum bilirubin with raised hepatic transaminases (ALT), were screened for HBV (hepatitis B virus), HCV (hepatitis C virus) and subsequently for HEV (hepatitis E virus). Acute hepatitis A, autoimmune hepatitis and Wilson's disease were excluded by doing appropriate test as and when required. The patients with hepatitis E were then monitored by checking their serial transaminases on day 1,4,8 and day 18 or until their transaminases dropped to normal. They were also clinically assessed and followed-up. RESULTS: Amongst the total admission of 1922 patients during one year period, 148 had acute hepatitis and out of these, 21 patients (14.189%) suffered from hepatitis E. Seventeen patients were below the age of 40. There were increased number of cases during the late summer and early winter seasons. Majority of the hepatitis E patients recovered during the short follow-up period of two weeks. Two patients had fulminant hepatitis. A four months pregnant young female died of her illness despite intensive treatment. CONCLUSION: Hepatitis E virus is fairly common cause of acute hepatitis in hospitalized patients. Most of the patients are having a benign self-limiting illness.