A Study of Seroprevalence and Co-infection of Hepatitis A and Hepatitis E Viruses in Sporadic Cases in an Endemic Area

Abstract

Context: Viral hepatitis is a serious health problem globally and in endemic countries like India. Viral hepatitis may present as mono-infection or co-infection caused by hepatitis A virus (HAV), hepatitis B virus, hepatitis C virus, hepatitis D virus, and hepatitis E virus (HEV). Co-infection with two or more viruses may lead to serious complications and increased mortality. To find out seroprevalence and co-infection of HAV and HEV infections in various age groups. Materials and Methods: This study was done retrospectively on 475 samples for HAV immunoglobulin M (IgM) and HEV IgM antibodies from the patients with a history of viral hepatitis between January 2015 and December 2015. HAV IgM antibody testing was done by chemiluminescent microparticle immunoassay, and HEV IgM antibodies were done by enzyme-linked immunosorbent assay. Results: Out of 475 samples, 181 samples were positive for HAV and/or HEV infection with an overall prevalence of 38.1%. Seroprevalence of HAV infection was found 9.4%, of HEV infection 23.3%, and of HEV-HAV co-infection 5.2%. Conclusion: HAV and HEV infections are a major cause of viral hepatitis in India. Although both the infections are self-limiting, co-infection in rare cases may lead to acute hepatic failure and worsen the prognosis. HAV infections are more prevalent globally but HEV now found more prevalent in sporadic cases because of available vaccination for HAV, timely diagnosis and improved living standards.

Keywords

• co-infection
• hepatitis a virus
• hepatitis e virus
• viral hepatitis.