The role of hepatitis E virus infection among patients with acute viral hepatitis in southern Saudi Arabia

Abstract

We investigated the etiology of acute sporadic viral hepatitis in southern Saudi Arabia in a series of 132 patients admitted with acute viral hepatitis. Of these cases, 108 (81.8%) were due to acute hepatitis A virus infection, of which 11 (8.3%) patients had been previously exposed to hepatitis E virus, and another 10 (7.6%) were chronic carriers of hepatitis B virus. Three cases (2.3%) were acute hepatitis B virus infection. The overall prevalence of hepatitis E IgG antibodies was found to be 9.1%. The remaining 21 (15.9%) patients were tested for hepatitis E IgM, EBV-VCA IgM and hepatitis C IgG antibodies by sensitive enzyme immunoassays. In none of them could hepatitis E IgM, EBV-VCA IgM or hepatitis C IgG antibodies be demonstrated, and these patients were thus considered as acute non-A, non-B hepatitis. Acute hepatitis C virus infection, however, could not be ruled out from this group. We therefore concluded that the majority of clinically apparent viral hepatitis cases were due to HAV, while HBV accounted for a small proportion of the cases. Clinically apparent HEV infection does not appear to be common in the population studied, since even those with serologic evidence of previous exposure to HEV did not recall a history suggestive of acute viral hepatitis.