Abstract
Geographical and ethnic diversity in Nepal has led to interesting epidemiology of viral hepatitis and liver diseases. Before the epidemic of Biratnagar that occurred in April to June 2014, Kathmandu was the only known endemic region for hepatitis E virus infection (HEV), where at least four previous epidemics have been documented since 1973. Due to rapid urbanization with still low socioeconomic condition, other major cities are appreciated to be at increasing risk of outbreaks. Characteristics of HEV epidemics and genetic changes of HEV during last decade have been studied. While hepatitis A virus infection was only common during childhood till recent years, it is re-emerging as an important etiology of acute hepatitis in young adults. Nepal is classified as low endemic region for hepatitis B virus infection (HBV) with overall seroprevalence of 1.1%. But, some ethnic groups and geographical areas have high prevalence rates. Despite low endemicity, HBV accounts for majority of cases of hepatocellular carcinoma and liver cirrhosis in the country. Similarly, though hepatitis C virus (HCV) is present in only 0.4% of general population, high seroprevalence was found among intravenous drug abusers many of them with HIV coinfection. Apart from hepatitis viruses, alcohol use also contributes significantly to liver cirrhosis and chronic liver failure. A unique form of hepatic venous outflow obstruction called ‘hepatic vena cava syndrome’ has been identified as an important etiology of liver cirrhosis and hepatocellular carcinoma.How to cite this articleShrestha A. Epidemiology of Viral Hepatitis and Liver Diseases in Nepal. Euroasian J Hepato-Gastroenterol 2015;5(1):40-42.
Highlights
HEPATITIS E VIRUS INFECTIONNepal is a small country sandwiched between India and China with population of 25 million people
Hepatitis E virus (HEV) infection is endemic in Kathmandu valley, with recurrent epidemics and sporadic cases in between
While hepatitis A virus (HAV) used to be very uncommon cause of acute hepatitis in adults till last decade; but, in recent years, it has been established as an important etiology in young adults
Summary
Nepal is a small country sandwiched between India and China with population of 25 million people. Very low prevalence of anti-HEV IgG is seen in the rural areas of Nepal compared to more than 90% of people above 50 years bearing the antibody in certain cities within Kathmandu valley.[1] Five major epidemics have been documented so far during 1973,2 1981 to 82,3 1987,4 2005 to 2006 and 2014.5 First four being in Kathmandu valley and fifth one occurred out of Kathmandu valley in the city of Biratnagar in 2014. The epidemics of 1973, 1981 to 82 and 1987 occurred even before the discovery of HEV which was labeled as NANB infection and later confirmed as hepatitis E on analysis of stored serum
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