The Role of Hepatitis E Virus Infection among Patients with Sporadic Acute Viral Hepatitis in Diyala Province


Abstract:Objective: To explore the role of hepatitis E virus (HEV) infection in sporadic cases of acute viral hepatitis in Diyala province.Materials and Methods: 163 patients with clinically and biochemically evident acute viral hepatitis. 96 (58.9%) were males with mean age (27 ± 18) years, and 67 females (41.1%) with mean age (24.3 ± 15.6) years. They were referred from outpatient clinic of Baquba General Hospital and other district hospitals in Diyala province during the period from October 2003 to August 004. Patient’s sera were submitted for the detection of anti-HEV IgM, anti-hepatitis A virus (HAV) IgM, anti-hepatitis C virus (HCV) antibody, and hepatitis B surface antigen (HBsAg), using Enzyme linked immunosorbant assays (ELISA), and determination of liver function tests using standard biochemical procedures.Results: The Total positivity rate of seromarkers was 69.3 %, while 30.7% of sera were negative for all viral markers. The rate of anti-HEV IgM was (30.1%) which was significantly higher (P < 0.001) than anti-HCV antibody (11.6%), HBsAg (6.1%), but insignificantly higher than anti-HAV IgM (21.5%). The rate of coinfection of HEV with HAV was 3.1%, with HBsAg was 1.2 % and with HCV was 0.6%. The anti-HEV IgM positivity rate was significantly higher (P< 0.05) among the age group (10-49) years compared to other age groups. There was insignificant difference in the infectivity rate between males and females (31.3% vs 28.4%). Similarly there was insignificant effect of residence (rural, urban) on the anti-HEV IgM positivity rate (26% and 33.3%) respectively. The source of water supply has insignificant effect (P>0.05) on the anti-HEV IgM positivity rate. The difference in the mean of liver function tests among patients with different types of viral hepatitis was statistically insignificant.Conclusion: Infection by HEV constitutes the highest proportion of sporadic acute viral hepatitis in Diyala province.