Fulminant viral hepatitis: Indian experience

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Abstract
Thirty‐six patients with fulminant viral hepatitis were studied. Enzyme immunoassay was used to detect the presence of HBsAg, IgM anti‐HBc, and IgM anti‐HAV. Non‐A, non‐B virus was the most common aetiological agent (61.1%) followed by hepatitis B virus (HBV; 30.6%) and hepatitis A virus (8.3%). Presence of IgM anti‐HBc confirmed the diagnosis of HBV infection in three cases who were negative for HBsAg. Similarly, in one case who was positive for HBsAg, absence of IgM anti‐HBc suggested superinfection with some other agent. Survival was significantly higher (P < 0.01) in the hepatitis A virus (HAV) group (66.6%) compared with non‐A, non‐B (31.2%) and HBV groups (27.3%). Fever at the onset of illness was seen in all patients with HAV, 54.5% of patients with HBV and 38.88% of patients with non‐A, non‐B infection (P < 0.01). The median time interval between the first symptom and the onset of encephalopathy was 16, 13 and 8 days in HAV, HBV and non‐A, non‐B groups, respectively, but this difference was statistically not significant (P > 0.05).