Acute viral hepatitis: the Indian scenario

Acute viral hepatitis (AVH) has been known to exist for centuries. New information about the molecular biology and epidemiology of various hepatotropic viruses has given fresh insight into the etiological and clinical spectrum of AVH. Hepatitis virus A, E and B are primarily responsible for causing acute hepatitis in the pediatric population. Hepatitis A virus is the most common cause of AVH among Indian children followed by Hepatitis E virus (HEV). They also constitute the most common cause for fulminant hepatic failure. It is not uncommon to find evidence for more than one viral infection in the same patient. The presence of bleeding, encephalopathy, deranged prothrombin time, high serum bilirubin, low alanine transferase and spontaneous bacterial peritonitis are indicators of poor prognosis. AVH superimposed on pre-existing chronic liver disease usually has an atypical course. In situations where the child has a preexisting hemolytic disorder jaundice is severe and recovery period is delayed. While earlier studies have shown a high HAV seroprevalence in pediatric age group, a declining trend has been noted in recent literature. While the control of HAV infection can largely be achieved by measures aimed at promotion of maintenance of hygiene, vaccination should be given consideration in select circumstances