Clinical profile of acute viral hepatitis in a tertiary care hospital of Odisha

Objectives: To describe the etiological and clinical profile of viral hepatitis and its outcome in a tertiary care hospital of Odisha. Methods: 71 children with jaundice were selected from dept. of Paediatrics, SCB MCH, Cuttack. Clinical examination, LFT & tests of viral markers of these children were done. Results: Most common age group of presentation was 5-10 years. Most of the children were male (61%). Majority (71%) were from rural areas. The most common signs & symptoms were jaundice (97.1%), fever (88.7%), nausea & vomiting (92,9%), splenomegaly (47.8%), ascites (19.7%), encephalopathy (22.7%) & GI bleed (9.8%). The common cause of viral hepatitis were hepatitis A (67.6%), hepatitis B (11.2%), hepatitis C(1.4%), hepatitis E (4.2%). No marker was detected in 14% of cases. The highest value of bilirubin total & direct were 44.6mg%, 13.6mg% respectively in the cohort. SGPT level was more than four times in all cases with highest 9350IU/L. PT was prolonged in 26.8% cases. 20(28.1%) cases which developed fulminant hepatic failure (FHF) were admitted to ICU out of which 9 patients recovered and 11 patients (16.71) died. Out of the 11 patients who died 9 patients (75%) had no viral marker. FHF due to hepatitis A singly is more common & 2 cases of Sickle cell disease with hepatitis A developed FHF more rapidly. 2 cases of hepatitis E developed FHF & recovered completely. Conclusion:-There is need of hepatitis A vaccination to young children, which will reduce the risk of infection in adolescents and adults through a herd immunity effect. Hepatitis B can be prevented by Universal immunization. Hepatitis C can be prevented by proper screening of blood and blood Products.