Seroprevalence of Hepatitis A Virus (HAV) and Hepatitis E Virus (HEV) Co-infection in the Patients Presenting with Acute Viral Hepatitis Attending a Tertiary Care Hospital in North India

Abstract

Introduction: Hepatitis A virus (HAV) and Hepatitis E virus (HEV) are both transmitted enterically, resulting in acute viral hepatitis (AVH) in developing countries like India. HAV has a world-wide distribution and affects infants and young children in developing countries, and its epidemics are not very common. HEV is restricted to tropical countries and affects older children and young adults, and its epidemics are common. Co-infection with both viruses may lead to serious complications. Aim: This study was done to determine prevalence of HAV and HEV in patients presenting with AVH and the co-infection of HAV and HEV in these patients. Materials and Methods: A cross-sectional study of one year’s duration was conducted in the Department of Microbiology, Dr. Ram Manohar Lohia Hospital, New Delhi. 1230 patients presenting with AVH were considered in the study. Serum samples were analyzed for IgM anti-HAV and IgM anti-HEV for the detection of HAV and HEV infection, respectively, using commercially available ELISA kits. Results: The seroprevalence of HAV- and HEV-positive patients was 15.5% and 27.2%, respectively. The seroprevalence of both HAV and HEV in patients with acute viral hepatitis was 5.1%. The prevalence of HAV and HEV among males (14.6% and 29.8%) was higher than in females (16.6% and 23.4%). These infections were predominantly seen during end of monsoons and beginning of winter. Conclusion: The prevalence of HEV is much higher than that of HAV; co-infection rate of 5.1% mandates the screening for HEV which will be of immense importance in pregnant women and improving levels of personal hygiene among lower socio-economic population.