CLINICAL FEATURES AND OUTCOME OF ACUTE HEPATITIS IN A TERTIARY CARE HOSPITAL, KARACHI

Abstract

Background: Acute hepatitis is a significant global health problem and a frequent cause of liver-related morbidity. The disease can manifest as a mild, self-limiting illness or progress to severe complications such as hepatic encephalopathy, coagulopathy, or acute liver failure. In countries with limited resources, poor sanitation and unsafe medical practices contribute to its persistence, while diagnostic delays worsen clinical outcomes. Identifying demographic, clinical, and laboratory predictors of prognosis is essential to improve timely recognition, guide management, and reduce the burden of disease.

Objective: This study aimed to determine the demographic, clinical, and laboratory characteristics of patients with acute hepatitis and to evaluate the association of these factors with clinical outcomes.

Methods: A descriptive cross-sectional study was conducted at the Department of Medicine, Jinnah Postgraduate Medical Centre, Karachi, enrolling 105 patients aged 13 years and above with confirmed acute hepatitis. Patients with acute-on-chronic liver disease or malignancy were excluded. Data on demographics, clinical symptoms, laboratory parameters, complications, and outcomes were collected using structured questionnaires and proformas. Statistical analysis was performed with SPSS version 20. Frequencies and percentages were calculated for categorical variables, and Chi-square tests assessed associations with outcomes, considering p < 0.05 statistically significant.

Results: Of the 105 patients, 68 (64.8%) were male and 37 (35.2%) female. The most common age group was 25–34 years (30.5%), followed by 35–44 years (23.8%). Jaundice was reported in 82 patients (78.1%), fatigue in 70 (66.7%), and nausea or vomiting in 60 (57.1%). Elevated ALT >200 IU/L was found in 88 patients (83.8%), AST >200 IU/L in 83 (79.0%), and bilirubin >2 mg/dL in 72 (68.6%). Complications occurred in 37 patients (35.2%), with hepatic encephalopathy in 15 (14.3%), coagulopathy in 14 (13.3%), and acute liver failure in 8 (7.6%). Recovery was achieved in 88 patients (83.8%), prolonged hospital stay occurred in 12 (11.4%), and mortality was recorded in 5 (4.8%). Complications showed a strong association with poor outcomes (p < 0.001), while elevated INR indicated a borderline association (p = 0.09). Other demographic and laboratory factors did not significantly affect prognosis.

Conclusion: Acute hepatitis presents with non-specific symptoms but carries a substantial risk of severe complications that determine prognosis. Early recognition and management of hepatic encephalopathy and coagulopathy are vital to improving survival and reducing hospitalization.