Abstract

Introduction: Acute viral hepatitis (AVH) continues  to  be a major public  health  burden  in developing  countries  like  India. Studies have previously documented a variable prevalence of hepatotropicviruses:  Hepatitis  A  Virus  (HAV)  (1.7‑67%), Hepatitis  B  Virus  (HBV)  (7.3‑42%),  Hepatitis  C  Virus (HCV)  (1.16‑10.6%)  and  HEV  (Hepatitis  E  Virus) (16.3‑66.3%)^[2,4]. As liver is an essential organ in lipid metabolism, several stages of lipid synthesis and transportation. Therefore, it is reasonable to expect an abnormal lipid profile in those with severe liver dysfunction. In  the  setting  of  acute  or  chronic hepatic  dysfunction  circulating  lipids  and  lipoproteins  are altered  with  respect  to  quantity  as  well  as  electrophoretic mobility and appearance. For reduced liver biosynthesis capacity, low levels of TG and cholesterol is usually observed in chronic liver diseases. This present study was conducted to assess the correlation between acute viral hepatitis with serum cholesterol and serum triglyceride values.

Methods: this is a case control analytical study, conducted among 50 presumptive cases of acute viral hepatitis, who admitted under department of general medicine, MGM Medical College & LSK Hospital, Kishanganj, Bihar during the period of April 2022 to January 2023.  Probable cases of acute viral hepatitis having clinical symptoms suggestive of hepatitis or liver Function Test Reports consistent with Acute Viral Hepatitis, And those cases that were sero-positive for either Hepatitis-A, B, C or E were included in the present study. Similar number of controls (n=50) were selected in the present study. All the controls were matched for non-modifiable risk factors such as gender and age.

Results: In this present study, patients with acute viral hepatitis at time of acute phase, Serum cholesterol, triglycerides, low density lipoprotein (LDL) were significantly higher (p<0.01) while high density lipoprotein (HDL) was significantly lower (p<0.01) in acute viral hepatitis compared to controls. Baseline parameters were similar between cases and controls (p>0.05). Jaundice (100%) and high coloured urine (100%) were the commonest presentations. Hepatitis A virus (56%) and Hepatitis E virus (32%) were commonest aetiological agents.  There was no statistically significant difference in the levels of very LDL between cases and controls (p>0.05). Complications were seen in 8 (16%) cases with hepatic encephalopathy being the commonest 4 cases (8%). Serum cholesterol, triglycerides, LDL were significantly higher and HDL was significantly lower in hepatitis with complications compared to uncomplicated hepatitis (p<0.01 ).

Conclusions: Acute viral hepatitis leads to significant alterations of serum lipid levels in blood. While total cholesterol, triglycerides and low density lipoprotein levels are higher, the levels of high density lipoproteins are lower during acute phase of viral hepatitis compared to controls.

Keywords: Acute viral Hepatitis, serum lipids.