Which of the following viral infections is associated with highest risk of progression to fulminant disease and acute liver failure:

Answer is D (HDV/HBV Superinfection) HDV superinfection of chronic Hepatitis B is associated with a 20 percent risk of progression to fulminant hepatitis and Acute Hepatic Failure. Feature HAV HCV HEV HBV Fulminant Infection 0.1% 0.1% 1-2 % HBV : 1 % (Acute Liver Failure) in HEV pregnant p HBV/HDV Co-infection : 5 % Women: 20% HDV/HBV Superinfection: 20 % Tendency to cause acute liver failure (fulminant infection) is highest with HDV Superinfection on Chronic Hepatitis B and Hepatitis E infection in pregnant women (up to 20 percent) Note: Hepatitis E is the most common cause of Acute Liver Failure in India Hepatitis B remains the most common viral agent responsible for Acute Liver Failure Worldwide Although Hepatitis E has a higher tendency to cause fulminant infection (1-2 %) in comparison to Hepatitis B infection (Up-to 1%), Hepatitis B is the most common cause of fulminant infection overall since the overall incidence of Hepatitis B Hepatitis is higher than the incidence of Hepatitis E Hepatitis Tendency to cause acute liver failure (fidminant infection) is highest with HDV Superinfection on Chronic Hepatitis B and Hepatitis E infection in Pregnant women (up to 20 percent)