Etiological Study of Acute Hepatocellular Jaundice With Special Reference to Acute Viral Hepatitis in North East India

Abstract

BACKGROUND: Acute viral hepatitis (AVH) due to Hepatitis-A virus infection (HAV) andHepatitis E virus infection (HEV) are considered as a major public health problem and is an important cause of morbidity and mortality both in developing and developed countries. Acute hepatocellular jaundice can be caused by viral hepatitis, drugs, toxins, other infections and alcohol. AIM: To determine the etiology of acute hepatocellular jaundice in a tertiary care hospital of North East India and to study the biochemical changes in cases of acute hepatocellular jaundice of different etiologies. SUBJECTS AND METHODS:The study involved 121 patients of hepatocellular jaundice admitted in different medicine wards of Assam Medical College and Hospital over a period of one year. Detailed clinical and biochemical investigations were carried out. Samples were tested for routine hemogram, liver function tests and serology for different hepatotropic viruses. RESULTS: Of all cases, 82 were of viral and 39 cases were of non-viral origin. Overall, maximum cases of acute hepatocellular jaundice occurred in third and fourth decade of life. HAV (39.02%) was most common cause, followed by HEV (18.29%), HBV (4.88%) and hepatitis C (1.2%). Among non-viral cases, 20 (51.28%) were due to Falciparum malaria, 7 (17.9%) due to drugs, 6 due to alcohol, 4 due to leptospira and 2 cases were due to mushroom poisoning. Serum bilirubin, ALT, AST, alkaline phosphatase (ALP) and PT were more altered in AVH group compared to non-viral group. CONCLUSION: Hepatitis A remains the commonest cause of acute hepatocellular jaundice and there is also an increasing trend for higher age group of hepatitis A infection as opposed to malaria in non-viral acute hepatitis. Biochemical changes were more marked in AVH.