Abstract

Introduction: Severe acute hepatitis (SAH) corresponds to a sudden and widespread impairment of liver functions. It remains a major cause of acute liver failure and hospital mortality worldwide. The incidence is poorly documented in Africa, a region with a high prevalence of viral hepatitis and where the use of traditional brews is very common. Therefore, this study aimed to identify the causes of severe acute hepatitis and analyze the
prognosis according to these causes in Gabon.
Patients and methods: This is a descriptive and analytical historico-prospective study conducted from May 30, 2016, to January 31, 2023, in the Hepato-Gastroenterology Department of the Libreville University Hospital. We included patients aged ≥15 years, without known chronic hepatitis, with a disease course of less than 26 weeks, presenting a marked elevation of transaminases > 10× normal, jaundice, and coagulopathy (INR ≥ 1.5 or PT ≤ 50%). Statistical analysis was performed using SPSS software version 25, including the chi-square, Fisher’s, and Student’s t-tests. The significance threshold was set at p < 0.05.
Results: Among the 1,698 patients hospitalized during the study period, 77 developed acute hepatitis, corresponding to a hospital frequency of 4.53%. The mean age was 37.9 years ± 16.92 years. Infectious etiology accounted for 53.73%. Hepatitis B accounted for 44.78% of all severe acute hepatitis cases and 83.33% of infectious causes, including 20% of delta co-infection. The mortality rate was 44.78%, which was higher.
Conclusion: Severe acute hepatitis is a common condition, likely underestimated. Its causes are primarily dominated by hepatitis B and the use of decoctions. Its prognosis is poor, marked by a mortality rate close to 50% regardless of the cause.

Keywords

Severe acute hepatitis, viral hepatitis, toxic hepatitis, Gabon