Hindistan kentsel kesimde bir üçüncü basamak hastanesinde fekal-oral yolla bulaşan viral hepatit

Amaç: Fekal-oral yolla bulaşan akut viral hepatit belirleyicilerinin sıklığı ve özellikleri ile yaş ve cinsiyet ilişkilerinin belirlenmesi. Yöntemler: Bu ileriye dönük araştırma klinik olarak infeksiyöz hepatitten şüphelenilen ve 600 hastayı içeren çalışma gurubu ve akut infeksiyöz hepatit kliniğine sahip olmayan ve 200 hastayı içeren kontrol gurubunda yapıldı. Hasta ve kontrol gurubuna ait serum örnekleri anti-hepatitis A virus (HAV) IgM ve anti-hepatitis E virus (HEV) IgM antikorlarının varlığı açısından ticari ELISA test kitleri ile tarandı. Bulgular: Çalışma gurubunda akut viral hepatit seroprevalansı % 11,8, kontrol gurubunda ise % 4,5 olarak belirlendi (p=0,007). Aynı gurupta anti-HAV IgM prevalansı % 8,3 ve anti-HEV IgM prevalansı %3,5 idi. Çalışma gurubunda en fazla anti-HAV IgM seropozitifliği 0-10 yaş gurubunda (%16,8), daha sonra 11-20 yaş gurubunda (%7,2) ve 21-30 yaş gurubunda (% 4,6) idi. Yine çalışma gurubunda en fazla anti-HEV IgM pozitifliği 21-30 yaş gurubunda (% 10,7) idi ve bu gurubu 31-40 yaş gurubu (% 2,9), 11-20 yaş gurubu (% 2,7) ve 0-10 yaş gurubu (% 0,9) takip ediyordu. Her iki tip akut viral hepatit için erkekler ağırlıktaydı. Sonuç: HEV infeksiyonu ağırlıklı olarak genç erişkin yaş gurubunda görülmekte iken, HAV infeksiyonu ağırlıklı olarak çocuk yaş gurubunda görülmekte ve prevalansı da yaşla birlikte azalmakta idi. Bu viral enfeksiyonların barsak yoluyla bulaşma özelliğinden dolayı aşılama programları ve halkın hijyen ve sağlıklı su tüketimi konusunda bilgilendirilmesinin gerektiğini düşünüyoruz.

Feco-orally transmitted viral hepatitis in a tertiary care hospital in urban India

Objective: To investigate the magnitude and pattern of hepatitis viral markers in feco-orally transmitted acute viral hepatitis with their relation to age and sex.Methods: This prospective study was carried out in two groups of subjects including the study group of 600 patients with clinically suspected infectious hepatitis and control group of 200 patients showing no clinical evidence of acute infectious hepatitis. Serum samples were tested for the presence of anti-hepatitis A virus (HAV) IgM and Anti-hepatitis E virus (HEV) IgM antibodies using commercial ELISA test kits.Results: The seroprevalence rate of feco-orally transmitted acute viral hepatitis was 11.8% in the study group compared to 4.5% in the control group (p=0.007). The prevalence of anti-HAV IgM was 8.3% while that of anti-HEV IgM was 3.5% in the same group. Maximum seropositivity of anti-HAV IgM was seen in 0-10 years of age in the study group (16.8%) followed by 11-20 years (7.2%) and 21-30 years (4.6%). In the study group, the maximum seropositivity of anti-HEV IgM was seen in 21-30 years (10.7%) followed by 31-40 years (2.9%), 11-20 years (2.7%) and 0-10 years (0.9%). Male predominance was seen in both types of acute viral hepatitis.Conclusion: While HEV infection was predominantly seen in young adults, HAV infection was predominantly a childhood infection and its prevalence decreased by age. Being enterically transmitted viral diseases it is recommended that immunization programs, public awareness measures for hygiene and safe drinking water should be consolidated. J Microbiol Infect Dis 2013;3(4): 181-185

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