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India has “intermediate to high endemicity” for hepatitis B infection and an estimated 40 million chronic hepatitis B infected people, constituting approximately 11% of the estimated global burden, stated Dr Arti Pawaria, consultant, Global Hospitals, Parel, Mumbai.
Dr Pawaria stated that hepatitis A is responsible for 10-30% of acute hepatitis and accounts for 5-15% of acute liver failure cases in India, while hepatitis E is responsible for 10-40% of acute hepatitis and 15-45% of acute liver failure in India.
However as per reports from major liver transplant centres across India, hepatitis C related end stage liver disease and liver cancer is the commonest cause among those who requires liver transplantation constituting ~ 31% of all cases of viral hepatitis followed by hepatitis B.
Approximately 30 to 40% of acute liver failure secondary to hepatitis E and A (in that order) requires liver transplantation as a life saving measure.
“Covid-19 associated hepatitis in children (CAH-C) results from involvement of liver secondary to Covid-19 infection. Children can present with abdominal pain, ascites (accumulation of fluid in abdominal cavity) or as mildly deranged liver function tests (rise bilirubin, AST, AST to 2-3 times upper limit of normal, low serum albumin) in those with moderate to severe infection,” added Dr. Pawaria.
However majority of CAH-C improves with usual management of Covid-19 infection. It is postulated that CAH-C could be more severe in children with pre-existing liver disease, but there is paucity of scientific data presently on this.
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