Nasir Khokhar1, Muzaffar Lateef Gill. 1. Division of Gastroenterology, Department of Medicine, Shifa International Hospital and Shifa College of Medicine, Islamabad. drnkhokhar@yahoo.com
Abstract
OBJECTIVE: To evaluate the serological profile of patients with incidentally detected positive hepatitis-B surface antigen (HBsAg) and to asses the risk factors. DESIGN: An observational study. PLACE AND DURATION OF STUDY: This study was conducted at Shifa International Hospital, Islamabad from 1999 to 2003. PATIENTS AND METHODS: All patients who presented to gastroenterology clinic of Shifa International Hospital, Islamabad with positive HbsAg, detected incidentally, were tested for alamine transaminase (ALT), hepatitis Beantigen (HbeAg) and in certain cases hepatitis-B virus DNA (HBV DNA) by polymerase chain reaction (PCR). Their risk factors for acquisition of infection were assessed with specific questions. RESULTS: A total of 224 patients were examined. One hundred sixty-four (73.2%) were male and 60 (26.8%) female. Mean age fo all the subjects was 32.45 -/+ 11.85 years. Out of 224 patients, 48 (21.4%) were positive for HBeAg and 176 (78.6%) were negative. Out of 48 subjects who were positive for HBeAg, 36 underwent HBV DNA determination and 32 (88.8%) were positive for HBV DNA. Out of 176 subjects who had negative HBeAg, 46 had elevated ALT and in those HBV DNA was performed and 14 had positive HBV DNA. Most common risk factors detected in these patients were intramuscular injections and surgery, however, in a large number, risk factors were unknown. CONCLUSION: Twenty-one percent asymptomatic subjects with positive HBsAg were found to be HBeAg positive. A large number of subjects with negative HBeAg had HBV DNA positive suggesting presence of precore mutants. Intramuscular injections and surgery were noted to be frequent risk factors in these subjects.
OBJECTIVE: To evaluate the serological profile of patients with incidentally detected positive hepatitis-B surface antigen (HBsAg) and to asses the risk factors. DESIGN: An observational study. PLACE AND DURATION OF STUDY: This study was conducted at Shifa International Hospital, Islamabad from 1999 to 2003. PATIENTS AND METHODS: All patients who presented to gastroenterology clinic of Shifa International Hospital, Islamabad with positive HbsAg, detected incidentally, were tested for alamine transaminase (ALT), hepatitis Beantigen (HbeAg) and in certain cases hepatitis-B virus DNA (HBV DNA) by polymerase chain reaction (PCR). Their risk factors for acquisition of infection were assessed with specific questions. RESULTS: A total of 224 patients were examined. One hundred sixty-four (73.2%) were male and 60 (26.8%) female. Mean age fo all the subjects was 32.45 -/+ 11.85 years. Out of 224 patients, 48 (21.4%) were positive for HBeAg and 176 (78.6%) were negative. Out of 48 subjects who were positive for HBeAg, 36 underwent HBV DNA determination and 32 (88.8%) were positive for HBV DNA. Out of 176 subjects who had negative HBeAg, 46 had elevated ALT and in those HBV DNA was performed and 14 had positive HBV DNA. Most common risk factors detected in these patients were intramuscular injections and surgery, however, in a large number, risk factors were unknown. CONCLUSION: Twenty-one percent asymptomatic subjects with positive HBsAg were found to be HBeAg positive. A large number of subjects with negative HBeAg had HBV DNA positive suggesting presence of precore mutants. Intramuscular injections and surgery were noted to be frequent risk factors in these subjects.