A 24-year-old woman in her third trimester of pregnancy presents with malaise, jaundice, and rapidly progressive encephalopathy over 10 days. ALT is 2400 U/L, INR 3.8. She has no history of drug intake, alcohol use, or viral risk factors. Which hepatotropic virus is the most likely cause?

• A Hepatitis A virus
• B Hepatitis B virus
• C Hepatitis E virus ✓
• D Hepatitis D virus

Explanation

HEV causes a self-limiting waterborne acute hepatitis in healthy adults but carries a mortality approaching 20 percent when acquired in the third trimester, typically from fulminant hepatic failure. This disproportionate severity in late pregnancy is the single most examined fact about HEV. Hepatitis A does not show this gravidity-related fatality pattern, and hepatitis B and D cause fulminant failure far less commonly in this setting.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.