A 24-year-old woman in her third trimester (32 weeks) presents with acute onset jaundice, fever, malaise, and elevated transaminases (ALT 1800 U/L, AST 1600 U/L). She recently traveled to an endemic area. Which viral etiology carries the highest risk of fulminant hepatic failure in this clinical setting?

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

Explanation

Hepatitis E virus (genotype 1 in endemic regions) causes acute hepatitis with a uniquely high mortality in pregnant women, especially the third trimester (up to 15 to 25 percent fulminant failure). HAV and HCV rarely cause fulminant hepatitis in pregnancy. HBV can cause acute liver failure but does not show the same predilection for pregnant women. This is a well-established epidemiology fact heavily examined in Indian exams.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.