Hepatitis E: a common cause of acute viral hepatitis.

OBJECTIVE: To investigate the etiology of acute hepatitis in adult patients admitted in a hospital.
METHODS: The study included all acute hepatitis patients admitted in the Infectious Diseases Unit of Rashid Hospital Dubai (JCI accredited), UAE, from January 2006 to December 2007. Various viral markers were used to establish the diagnosis of acute hepatitis which included anti HAV IgM, HBsAg, Anti HBc IgM), anti HCV IgG and anti HEV IgM by ELISA. In hepatitis C positive cases HCV RNA was also done to confirm acute HCV. Liver function test weres done by Hitachi 912 machine.
RESULTS: A total of 165 cases with acute hepatitis were admitted in the hospital during the study period. The specific etiologic diagnosis could be made in 122 (74%) patients and of these acute hepatitis E was found in 40%, HAV in 18.7%, HBV in 11.5%, HCV 1.2%, and combined infection 4.2%. Overall, HEV accounted for 54% of acute viral hepatitis. Majority (95.4%) of HEV patients were from developing countries which included 69.5% patients from Nepal, 52.7% from Bangladesh, 48.8% from India and 30.7% from Pakistan. The mean age of the patients with HAV infection was significantly younger than patients with HEV and HBV, p value < .0001 and < .0002 respectively. Prothrombin time was longer in HAV infection than HBV and HEV, (p < .01 and < .02) respectively. However, there were no significant differences in serum bilirubin and transaminases concentration among different groups.
CONCLUSION: The present study showed that about 60% of the acute viral hepatitis is water borne and can be easily controlled with improving sewage and water distribution and personal hygiene.