Seroprevalence of Hepatitis A Virus and Hepatitis E Virus Among Patients With Acute Viral Hepatitis in a Tertiary Care Hospital: A Retrospective Study

Background and objectives: Hepatitis A virus (HAV) and hepatitis E virus (HEV) infections cause acute viral hepatitis. Increased cases of HAV and HEV infection in the Indian subcontinent could be attributed to the region's large population. We conducted this study to determine the seroprevalence of HAV and HEV infections in our hospital. We also evaluated the symptoms (e.g., fever, jaundice, pain abdomen, and loose motion), liver enzymes like serum glutamic-oxaloacetic transaminase (SGOT) and serum glutamic-pyruvic transaminase (SGPT), and serum total bilirubin levels of the study participants. Methods: This retrospective study analyzed the patients with suspected acute viral hepatitis who visited Kalinga Institute of Medical Sciences (KIMS), Bhubaneswar, India, between January 2023 and November 2025. We included the blood samples received for anti-HAV IgM and anti-HEV IgM testing during the study period. We presented the symptoms and their durations through highlight plots. The trend of symptoms was assessed for the three years. We demonstrated SGOT, SGPT, and serum total bilirubin levels in patients with HAV-, HEV-, and co-infection through violin and box-and-whisker plots. Their trends were also analyzed for the three years. Results: We analyzed 3,607 samples from patients suspected of acute viral hepatitis. The median age was 25.0 (interquartile range (IQR), 16.0-43.0) years. The study population had 1346 (37.32%) female and 2261 (62.68%) male patients. In 2023, 2024, and 2025, there were 878, 1189, and 1540 acute viral hepatitis cases, respectively. Abdominal pain was the most common presenting symptom (n=1703, 47.21%), followed by fever (n=1529, 42.38%), jaundice (n=1375, 38.12%), and loose motion (n=441, 12.22%). HAV and HEV infections were seen in 1567 (43.44%) and 147 (4.08%) participants, respectively. A total of 134 (3.71%) participants had both infections, and the remaining 1759 (48.77%) were negative for both viruses. The median SGOT values of participants with HAV, HEV, and both infections were 508.40 (IQR, 406.70-930.75) IU/L, 502.70 (IQR, 409.40-1631.70) IU/L, and 516.95 (IQR, 416.90-1155.70) IU/L, respectively. The median SGPT values of participants with HAV, HEV, and both infections were 543.90 (IQR, 404.45-898.05) IU/L, 532.20 (IQR, 392.70-1722.35) IU/L, and 544.70 (IQR, 393.43-1077.30) IU/L, respectively. The median serum total bilirubin values of participants with HAV, HEV, and both infections were 5.07 (IQR, 2.92-7.22) mg/dL, 5.42 (IQR, 3.11-7.31) mg/dL, and 4.72 (IQR, 2.92-6.87) mg/dL, respectively. Conclusion: The number of cases increased with each year. HAV was more common than HEV and co-infection. The liver enzymes and serum total bilirubin levels were elevated in infected participants compared with non-infected participants. Owing to India's large population, HAV and HEV infections are serious public health concerns. Early detection, diagnosis, and treatment of suspected cases of HAV and HEV infection could thereby lessen the strain on hospitals and lower morbidity and death.