ACUTE VIRAL HEPATITIS www.pgmeeuploads.com
 Most Common cause of acute viral hepatitis world wide = Hepatitis A.
 Most Common cause of acute viral hepatitis in children world wide = Hepatitis A
 Most Common cause of acute viral hepatitis in adults worldwide = Hepatitis E
INDIA - ACUTE VIRAL HEPATITIS
 Most Common cause of acute viral hepatitis in india Overall and adults (Endemic/sporadic) = Hepatitis E www.pgmeeuploads.com [ Ref : HEV infection accounts for more than 30% to 60% of cases of sporadic acute hepatitis in India, exceeding the frequency of HAV. (Robbins 9ed page 835) ]
The cases in these areas are caused mostly by infection with genotype 1 virus, and much less frequently by genotype 2 virus.
 Most Common cause of acute viral hepatitis in india in child = Hepatitis A
FULMINANT VIRAL HEPATITIS
Most common cause for fulminant hepatitis = Hepatitis B - Hepatitis D infection ( In option Only Hepatis D may be given which implies the same as hepatitis D infection is always with Hepatitis B )> Hepatitis E www.pgmeeuploads.com
NOTE = Co-infecton of hepatitis B and D is more likely to lead to fulminant hepatitis than superinfection of hepatitis B and D.
Hepatitis B accounts for >50% of fulminant cases of viral hepatitis, a sizable proportion of which are associated with HDV infection. Hepatitis E, as noted above, can be complicated by fatal fulminant hepatitis in 1- 2% of all Cases and in up to 20% of cases in pregnant women. Note that Prevalence of Hepatis B is much higher than Hepatis E. [ Harrison's Principles of Internal Medicine-19th Edition page 2018]. www.pgmeeuploads.com
CASE FATALITY RATE = Hepatits D > Hepatitis E > Hepatitis A & B > Hepatitis C www.pgmeeuploads.com
The case fatality rate in hepatitis A and B is very low = (0.1 %) .
Hepatitis C is less severe during the acute phase than hepatitis B. In outbreaks of waterborne hepatitis E in India and Asia, the case fatality rate is 1- 2% and up to 10- 20% in pregnant women. Although the case fatality rate for hepatitis D is not known definitively, in outbreaks of severe HDV infection in isolated populations with a high hepatitis B carrier rate, a mortality rate >20% has been recorded.
CHRONIC VIRAL HEPATITIS
 Most Common cause of cause of chronic Viral Hepatitis = Hepatitis C > Hepatitis B www.pgmeeuploads.com
 Chronicity rate is maximum in = Hepatitis C (80-90%) > Hepatitis B (5-10%)
[ In contrast to HBV, chronic disease occurs in the majority of HCV-infected individuals (80% to 90%) and cirrhosis eventually occurs in as many as a 20% of individuals with chronic HCV infection.
 Most common cause of cirrhosis = Hepatitis C. www.pgmeeuploads.com
NOTE - Only 5-10 of Hepatis B infection develop chronic viral infection and 20-30 % of " these" chronic cases develop cirrhosis whereas in case of hepatitis C chronic disease occurs in the majority of HCV-infected individuals (80% to 90%) and cirrhosis eventually occurs in as many as a 20% of individuals with chronic HCV infection. So Most common cause of cirrhosis = Hepatitis C > Hepatitis B.
[ Long-term morbidity and mortality in patients with chronic hepatitis C is more in black than in white patients and lowest in those infected with HCV genotype 2 and highest in those with HCV genotype 3.
 Most Common cause of Viral Hepatitis causing HCC = Hepatitis B [www.pgmeeuploads.com Ref : More than 85% of cases occur in countries with high rates of chronic HBV infection. Robbins 9ed Page 870]
Overall, 75% to 80% of HCC cases are related to HBV (50% to 55%) or HBC (25% to 30%) infections. [ Ref Sabiston Textbook of Surgery - The Biological Basis of Modern Surgical Practice, 19E Page 1453]
 Which is more carcinogenic = Hepatitis B > Hepatitis C
TRANSFUSION ASSOCIATED HEPATITIS
Most common type of hepatitis associated With transfusion-= Hepatitis B (Harrison 19/e Table NO 138e-3)