Spectrum of Hepatitis B infection in a Tertiary Care Centre A cross sectional analysis
Abstract
Background Hepatitis B virus related liver
disease is not an uncommon problem in
India. There are very few reports on pattern
of chronic hepatitis B virus infection
in a tertiary care centre from South India.
The aim of the present study was to
determine the spectrum of chronic Hepatitis
B virus infection amongst patients
attending the liver clinic in a tertiary referral
centre. Methods Hepatitis B surface
antigen positive patients registered in the
liver clinic between July 2010 and Mar
2011 were included in the study. Totally
189 patients were included in the study.
Based on the viral profile, transaminase
levels and ultrasound findings, patients
were categorized as immunotolerant, inactive
carriers, immune clearance and
reactivation phase, chronic liver disease
(chronic hepatitis, cirrhosis) and hepatocellular
carcinoma.Results Among the
189 patients, 64 of them were asymptomatic
and incidentally detected to be
positive for HBsAg. One patient was
positive for both HBV and retrovirus, and
3 were positive for HBV and HCV. In the
immune tolerant phase (13.2), women
were a decade younger than their male
counterparts. The mean HBV DNA values
were significantly high in HBeAg
positive patients. 35.9 of patients were in
the immune inactive phase . ALT levels
were in the normal range and HBV DNA
values were either low or not detectable
in this phase.Amongst patients with elevated
ALT and HBV DNA levels (50.8) in
immune clearanceimmune reactive
phase, HBV DNA levels were high in
HBeAg positive patients (either sex). In
all the 3 groups, there was no correlation
between HBsAg quantitative and HBV
DNA levels. Nine patients (4.8) had HBV
related HCC. The mean age was 55
years. Five of the 9 patients had very low
HBV DNA levels, 3 were HBeAg positive
and remaining negative. Conclusion In
this study, 50.8 of patients were in immune
clearance and reactive phases required
treatment with antiviral drugs.
Rest of the patients (49.2) were in immune
tolerant and inactive carrier phases
and they require meticulous follow up.
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