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Role of non-hepatotropic viruses in acute sporadic viral hepatitis and acute-on-chronic liver failure in adults

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Abstract

Background

Acute viral hepatitis (AVH) is mostly caused by hepatitis E (HEV) and hepatitis A (HAV) viruses in India. This study was undertaken to find out the incidence of various hepatotropic and non-hepatotropic viruses in AVH and acute-on-chronic liver failure (ACLF) patients.

Methods

Six-hundred and seventy-three adult patients of AVH and ACLF were screened for acute serological markers of hepatotropic (A, B, C, D, and E) and the non-hepatotropic cytomegalovirus (CMV) and Epstein-Barr virus (EBV).

Results

Viral etiology profile in 295 samples with confirmed etiology were HEV in 155 (52.5 %); HAV in 43 (14.5 %); HBV in 35 (11.8 %); HCV in 1 (0.3 %); mixed viral etiology in 30 (10.1 %); and non-hepatotropic viruses, cytomegalovirus, and Epstein-Barr virus in 31 (10.5 %). Two-hundred and six patients (69.8 %) were AVH and 89 (30.1 %) ACLF. HEV was the commonest cause of infection in both the groups AVH (n = 95, 46.1 %) and ACLF (n = 60, 67.4 %). Twenty-nine (9.8 %) patients died on follow up; mortality was higher in ACLF (25/89, 28 %) than AVH group (4/206, 1.94 %; p < 0.001). The mortality was higher when HEV was the cause of acute event (20/29, 68.9 %). In AVH, mixed infection was more common as compared to ACLF (27 vs. 3, p < 0.001). Non-hepatotropic viruses contributed significantly higher infections in AVH as compared to ACLF (29 vs. 2, p = 0.002) patients.

Conclusions

HEV was an important cause of symptomatic hepatitis in both AVH and ACLF patients. Non-hepatotropic viruses like CMV and EBV were identified in a significant number of patients with AVH and much less frequently in ACLF.

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Authors and Affiliations

  1. Institute of Liver and Biliary Sciences, D-1, Vasant Kunj, New Delhi, 110 070, India

    Ekta Gupta, Neha Ballani, Manoj Kumar & Shiv Kumar Sarin

Authors
  1. Ekta Gupta
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  2. Neha Ballani
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  3. Manoj Kumar
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  4. Shiv Kumar Sarin
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Correspondence to Ekta Gupta.

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EG, NB, MK, and SKS declare that they have no conflict of interest.

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The authors affirm that the study was performed in a manner to conform with the Helsinki Declaration of 1975, as revised in 2000 and 2008 concerning human and animal rights, and that the authors followed the policy concerning informed consent as shown on Springer.com.

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Gupta, E., Ballani, N., Kumar, M. et al. Role of non-hepatotropic viruses in acute sporadic viral hepatitis and acute-on-chronic liver failure in adults. Indian J Gastroenterol 34, 448–452 (2015). https://doi.org/10.1007/s12664-015-0613-0

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  • DOI: https://doi.org/10.1007/s12664-015-0613-0

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