<prompt> Which of the following viral infections is associated with highest risk of progression to fulminant disease and acute liver failure:HEV infectionHBV InfectionHBVHDV coinfectionHDV HBV Superinfection  <response>: Answer is D HDVHBV 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 HBVHDV Co-infection : 5 Women: 20 HDVHBV 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 