Javed Ahmed Phulpoto, Syed Iftikhar Ali Shah, Zulfiqar Bhatti.
The frequency of different disease patterns of hepatitis B virus in incidentally detected asymptomatic healthy hbsag positive patients.
Med Channel Jan ;17(2):72-72.
Objective To determine the frequency of different disease patterns of Hepatitis B virus in incidentally detected asymptomatic healthy HbsAg-positive patients, attending Liver clinic of Ghulam Mohammad Mahar Medical College, Sukkur. Study Design: Prospective observational study Place of Study: Liver clinic, Ghulam Mohammad Mahar Medical College, Sukkur. Duration of Study: From January 2009 to June 2010 Methodology: One hundred twenty two incidentally detected asymptomatic healthy HBsAgpositive subjects (IDAHS), in whom HBsAg positivity persisted for >6 months, were studied for liver biochemistry, HBeAg, anti HBe and HBV DNA levels. Liver biopsy was done in 58 subjects and scored for histological activity index (HAI) and fibrosis using modified Knodell score. Results: Twenty six (21%) subjects were HBeAg positive. The remaining 96 (79%) were positive for anti HBe, with HBV DNA level of >105 copies/mL in 30 (31.2%). Transaminase elevation was more frequent in HBeAg-positive subjects (69%; p<0.05) and in HBV DNApositive (93%) than in non-replicative (27%) infection. Seroconverted (anti HBe-positive) individuals were a decade older than HBeAg-positive ones and most (93.7%) of them were >20 years of age. Thirty of 58 (51.3%) had HAI >3, more frequently in those with raised ALT (68.4%; p<0.05) than with normal ALT (20%), but there was no difference in relation to HBeAg status. Conclusions: Seroconversion to anti HBe was noted in individuals aged 20 years or more. Ongoing liver disease was noted in approximately half of IDAHS, suggesting that a considerable proportion of IDAHS have active infection. In HBeAg-negative subjects, transaminase estimation may be sufficient in planning therapy.
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