Evidence of hepatitis A virus infection in the patients with acute encephalitis syndrome in Gorakhpur region, North India

Acta Virol. 2018;62(2):208-213. doi: 10.4149/av_2018_215.

Abstract

The etiological agent remained unidentified in a large number of patients hospitalized for acute encephalitis syndrome (AES) in 2008-2009 in Uttar Pradesh and Bihar, north India. All patients were found to present with fever and altered sensorium, while 28%, 19% and 13% showed hepatomegaly, splenomegaly and meningeal signs, respectively. Involvement mostly of children with abnormal hepatic features prompted us to undertake an exploratory study on viral hepatitis A to determine its association, if any, with hepatic derangements. AES patients (n = 2515) and healthy children (n = 167) were investigated for the presence of serum anti-hepatitis A virus (anti-HAV) IgM and anti-Japanese encephalitis (anti-JE) virus IgM by ELISA. Cerebrospinal fluids (CSFs, n = 595) and rectal swabs (n = 182) were examined for anti-HAV IgM and/or HAV RNA. Anti-HAV IgM was detected in the sera of 14.6% patients as against 6.6% of healthy children (p = 0.0042). Anti-JE virus IgM positivity was Keywords: acute encephalitis syndrome; cerebrospinal fluid; hepatitis A virus; anti-HAV IgM; non-Japanese encephalitis.

MeSH terms

  • Acute Febrile Encephalopathy / blood
  • Acute Febrile Encephalopathy / diagnosis
  • Acute Febrile Encephalopathy / epidemiology
  • Acute Febrile Encephalopathy / virology*
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antibodies, Viral / blood
  • Child
  • Child, Preschool
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Hepatitis A / blood
  • Hepatitis A / diagnosis
  • Hepatitis A / epidemiology
  • Hepatitis A / virology*
  • Hepatitis A virus / genetics
  • Hepatitis A virus / physiology*
  • Humans
  • India / epidemiology
  • Infant
  • Male
  • Middle Aged
  • Young Adult

Substances

  • Antibodies, Viral