Spectrum of Hepatitis B Infection in a tertiary care centre of eastern India

Dr. Manoj Kumar Gupta; Kumkum Sarkar; Soumendra Nath Haldar; Dr. D Gonjhu; Dr. N. Pramanik; Prof. S. K. Guha

Volume : IX, Issue : VII, July - 2019

Spectrum of Hepatitis B Infection in a tertiary care centre of eastern India

Dr. Manoj Kumar Gupta, Kumkum Sarkar, Soumendra Nath Haldar, Dr. D Gonjhu, Dr. N. Pramanik, Prof. S. K. Guha

Abstract :

Background and Aim: Hepatitis B virus (HBV) infection is a global health problem. HBV– related liver disease is not uncommon in India. There are very few report on spectrum of hepatitis B infection from eastern India. In this study we shall try to elaborate the spectrum of hepatitis B infection of those patients among patients attending the Virology OPD in a tertiary referral center. Materials and Methods: Hepatitis B surface antigen (HBsAg) positive patients registered in the Tropical Medicine Virology OPD or who were admitted under Tropical Medicine department between July 2017 and December 2018 were included in the study. All patients had baseline liver function tests, serological markers for HBV infection (hepatitis B e antigen [HBeAg], anti–HBe, anti–HBc IgM and total, and HBV DNA quantification), and ultrasound. Serum alpha–fetoprotein was done only in elderly (>50 years) patients. Based on the viral profile and transaminase levels and ultrasound findings, patients were categorized as HBeAg pos chr infection or immune tolerant, HBeAg pos chr hepatitis or immune reactive, HBeAg neg chr infection or inactive carrier, HBeAg neg chr hepatitis and chronic liver disease with compensated cirrhosis or Decompensated cirrhosis. Results: Majority of patients were asymptomatic and incidentally detected to be positive during any health checkup, pre–anesthetic checkup, pregnancy or blood donation camps. Among the study population 29% of patients were in immune inactive carrier phase and 49% had features of chronic hepatitis without features of cirrhosis. Alanine aminotransferase (ALT) levels were similar in both HBeAg–positive and negative patients. HBV DNA quantity was significantly high in patients who were HBeAg positive. Conclusion: A significant proportion of HBsAg–positive patients is in HBeAg negative chronic infection or inactive carrier phase and do not require treatment. Patients with elevated ALT and HBV DNA levels need further evaluation to categorize them into immune clearance or immune reactive phase