Viral etiology and assessment of HBV genotypes in Fulminant Hepatic Failure: the present scenario

  • Hiba Sami Assistant Professor Department of Microbiology SRMSIMS, Bareilly
  • Meher Rizvi
  • Mohd Azam
  • M R Ajmal
  • Indu Shukla
  • Haris M Khan
Keywords: fulminant hepatic failure, Genotype D, HAV, HCV, HEV, Viral hepatitis,


Background: Fulminant hepatic failure (FHF) is defined as the rapid development of acute liver injury with severe impairment of synthetic functions and hepatic encephalopathy in patients without obvious previous liver disease. The present study was carried out to evaluate the etiology of FHF on one hand and to assess the role of HBV genotypes in acute liver failure in India on the other hand.Methods: The patients who developed fulminant hepatic failure (FHF) were screened for HAV, HBV, HCV, HEV and HIV and Hepatitis B Core IgM, HBeAg, anti-HBs and anti-HBe were assessed. HBV genotyping was performed using Kirschberg’s type specific primers (TSP-PCR), heminested PCR, and Naito’s monoplex PCR. SEN and TTV viruses were detected in Non-A to Non-E hepatitis (NANEH).Results: Majority of FHF were detected in HBV 13 (38.2%) followed by 12 (35.3%) HEV. There were 8(23.5%) cases of NANEH. 3(0.88%) and 1(0.29%) of the NANEH cases were positive for SEN and TTV viruses respectively. Genotype D was the most prevalent HBV genotype 7(55.55%) followed by genotype F 2(15.38%) and genotype A (7.69%).Conclusion: FHF continues to be a major challenge for the clinician because of its high mortality rate and the requirement for a multidisciplinary approach. 


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Original Article