PREVALENCE OF HEPATITIS A VIRUS, HEPATITIS B VIRUS, AND HEPATITIS C VIRUS, AMONG PATIENTS WITH HEPATIC JAUNDICE IN SANA’A CITY, YEMEN: A HOSPITAL BASED STUDY
Authors: Al-Shami Huda Zaid , Al-Mutawakal Zaid Ali Mohammed , Al-Kholani Abdulwahab Ismail Mohamed , Al-Haimi Muhamed Ahmed , Al-Haddad Ahmed Mohammed , Ahmed Redhwan A. , Al-Somainy Ali Abdullah , Al-Shamahy Hassan Abdulwahab 
Published: January 2022

Background: Hepatic jaundice results from abnormal metabolism of bilirubin in the liver. The main hepatic jaundice causes are severe damage to hepatocytes due to autoimmune diseases, infectious diseases, drugs/ medication induced, or, less commonly, hereditary genetic diseases.
Aim: The aim of this study is to determine the prevalence of hepatitis B Virus (HBV), hepatitis A virus (HAV), and hepatitis C virus (HCV), in patients with hepatic jaundice as causes of acute viral hepatitis (AVH) in Sana'a city, Yemen.
Subjects and Methods: Data of patients with hepatic jaundice tested for hepatitis B surface antigen, total anti-HCV antibody, and anti-HAV immunoglobulin M (IgM) by enzyme-linked immunosorbent assay were collected from Class I Viral Diagnostic Laboratories in Sana'a for 3 years. Then the statistical analysis of the data was used where the descriptive analysis was calculated: frequency and percentage, as well as the association of infection with sex and age group by means of detection odds ratio, 95% CI and X2 more than 3.9 and P<0.05 were considered statistically significant.
Results: The study included 644 males (43.8%) and 826 females (56.2%), while most patients were less than 21 years old. The rate of Hepatitis viruses positive was 27.6% positive. Hepatitis A virus infection was the most common virus diagnosed accounting for 259 cases (17.6% of the total), while HBV was less common with 104 (7.1%) and HCV only 42 cases (2.9%). The highest incidence of hepatitis B was in 11-20 years patients (18.2%), with an associated OR 9.3 (p < 0.0001). The highest incidence of hepatitis C was in 31-40 years patients (7.3%), with an associated OR 3.3 (p<0.0001).
Conclusion:  Alarmingly changing the epidemiology and dynamics of hepatitis A-C viruses in Yemen, a detailed study is required to understand the definite disease problem caused by these viruses. It is noticeable in this study the high prevalence of hepatitis A virus and hepatitis B virus in the Yemeni population with hepatic jaundice. Also, to our knowledge, this study is the first to report epidemiological transformation of hepatitis A virus in Sana'a, Yemen.
                   
Peer Review History:
Received: 13 November 2021; Revised: 11 December; Accepted: 30 December, Available online: 15 January 2022
Academic Editor: Dr. Nuray Arı, Ankara University, Turkiye, ari@ankara.edu.tr
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Received file:                Reviewer's Comments:
Average Peer review marks at initial stage: 5.5/10
Average Peer review marks at publication stage: 7.0/10
Reviewers:
Dr. Gulam Mohammed Husain,, National Research Institute of Unani Medicine for Skin Disorders, Hyderabad, India, gmhusain@gmail.com
Dr. Salfarina Ramli, Department of Pharmacology and Pharmaceutical Chemistry, Faculty of Pharmacy, Universiti Teknologi MARA, 42300 Puncak Alam, Selangor, Malaysia. salfarina2892@uitm.edu.my  
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