Seroprevalence of Hepatitis E Virus and Serum Level of Serum Aspartate Transaminase (AST) and Alkaline Phosphatase (ALP) Among Jaundice Patients in Kathmandu Valley, Nepal

Abstract

Hepatitis E is an acute disease caused by hepatitis E virus that usually manifest as acute jaundice. It is a waterborne infection and occurs sporadically or as epidemic outbreaks. Hepatitis E virus (HEV) is a positive-stranded RNA virus with a 7.2  kb genome with three open reading frames In this study we report the seroprevalence of HEV in different categories of jaundice patients along with their elevation of serum bilirubin, AST and ALT level indicating the level of hepatic cell damage and hepatic obstruction . Blood samples were collected from the icteric patients admitted in the hepatic and gastro department of both the hospitals, Bir hospital, Mahabaudha and Nardevi Ayurvedic hospital Nerdevi. A total of 90 samples were screened for bilirubin using colorimetric method, liver enzymes using automated method and HEV using ELISA method. The seroprevalence of HEV was 43.3% (95% CI). There were no significant differences of HEV seropositivity between the male and female patients. Age groups were statistically associated with seropositivity, adolescence (age below 19) where likely to have highest seropositivity followed by mid age (between 20 and 50 years) and lowest in old (age above 60). There was significant difference in Mean Rank of alanine aminotransferase between HEV seropositive (57.55) and HEV seronegative (36.28) (Man-Witney U=524.5, p=0.001). There was significant difference in Mean Rank of aspartate aminotransferase between HEV seropositive (54.91) and HEV seronegative (38.30) (Man Witney U=627.5, p=0.003). In conclusion Hepatitis E is an acute self-limiting disease caused by hepatitis E virus that usually manifest as acute jaundice. It is associated with increased serum bilirubin, serum AST and serum ALP level. The seroprevalence of HEV is high as compared to other hepatitis and it is an important cause of morbidity and mortality in young adults of Kathmandu.

Keywords: Hepatitis E, Hepatitis E virus (HEV) seroprevalence, Icterus, serum AST serum ALP