Original Article
English
Nagat Bousifi
Infectious Department, Tripoli central Hospital Tripoli, Libya
JMJ 2009,Vol.9, No.2: 98-101
Abstract
Back Ground: The proportion of HBV carriers who develop chronic hepatitis and need treatment is unknown. It is believed that HBV DNA less than 105 copies/ml is indicative of mild histological lesions and considered as a limit to start therapy. Aim: Is to identify HBV carrier who might be candidate for antiviral therapy, and to study the epidemiological, biochemical, viral, and histological characteristics of newly diagnosed HBV patients. Patients and methods: A cohort of 139 newly diagnosed HBsAg carriers who were referred to virology clinic in central hospital in the period between June 2002 and May 2005 were included. All were registered using a standard data form and tested for ALT, HBeAg, and HBV DNA levels. Liver biopsy was done mainly to patients with high HBV DNA levels (>10), abnormal ALT levels, and most of HBeAg-positive patients. The patients divided into two groups depending on the HbeAg status and a comparison study of epidemiological, and clinical data, including treatment need of both groups was done using Wilcoxon, and chi-square tests. Results: 139 patients (71% males, mean age 31.5 yrs). HbeAg was negative in 75.5%. HBV DNA level was below limit of detection in 20%, intermediate in 36%, and > 105 in 44% of patients. Liver biopsy was done in 60 patients. Fibrosis (F1-F4) found in, 23/43(53.5%) of patients with high viremia (10), 10/14 (71.4%) of patients with intermediate viremia. Cirrhosis was found in 2/3(66.6%) of patients with HBV DNA below level of detection. In the comparative study showed that HBeAg-negative patients tend to be older (p<0.05), high cirrhosis rate (p<0.001). HBeAg-positive patients tend to have abnormal ALT levels (p<0.05), High serum HBV DNA level (<0.001), and > 2 family members affected, and absence of fibrosis in liver histology. Only 25% of HBeAg-negative patients started therapy, whereas 56% of HbeAg-positive patients were treated. Conclusion: HBeAg-negative chronic hepatitis B is prevalent in Tripoli. HBV DNA limit of >105 may not be considered as the cut off limit in the decision of starting therapy and has to be correlated with other clinical and laboratory parameters.
Keywords: Chronic hepatitis B, HBeAg-positive, HBeAg-Negative, Cirrhosis.
Link/DOI: http://www.jmj.org.ly/PDF/summer2009/98.pdf