Skip to main content

Clinical, laboratory, and virological characteristics of patients with positive hepatitis B surface antigen in Upper Egypt

Abstract

Background

Hepatitis B virus (HBV) infection is a major cause of morbidity and mortality, particularly in developing countries.

Aim

The aim of the study was to determine the clinical, laboratory, and virological characteristics of patients with chronic HBV infection in Upper Egypt.

Patients and methods

This descriptive, cross-sectional study included 252 patients with positive hepatitis B surface antigen (HBsAg). It was conducted in the Tropical Medicine and Gastroenterology Department and Outpatient Clinic, Assiut University Hospital (Egypt), from May 2012 to May 2014. All patients underwent clinical evaluation, were administered a questionnaire about risk factors for transmission of HBV, underwent liver function tests, abdominal ultrasonographic examination, and complete blood count, evaluation of serological markers of HBV, and quantitative detection of HBV-DNA.

Results

Of the 252 patients included, 88.5% were male with a mean age of 35.4 years. Arthralgia was the most common complaint (15.5%) and hepatomegaly was the most common finding (8.3%). As regards imaging results (ultrasonographic) the following were found: normal liver in 83.3%, coarse liver in 11.9%, hepatomegaly in 7.5%, splenomegaly in 6.3%, and cirrhosis in 5.9%. As regards laboratory results normal alanine aminotransferase was found in 79.8%, normal aspartate aminotransferase in 85.7%, reduced serum albumin in 4.4%, and low platelet count in 9.9%. The majority of patients (91.7%) were hepatitis B envelope antigen negative; 65.9% of patients were positive for HBV on PCR. No significant differences were found between positive HBV-DNA status (by PCR) and negative HBV-DNA status as regards clinical, imaging, and laboratory characteristics of patients.

Conclusion

Most of the patients had normal liver on ultrasonographic examination and normal liver function tests. No significant difference was found between positive HBV-DNA status (by PCR) and negative HBV-DNA status as regards clinical, imaging, and laboratory characteristics of patients.

References

  1. Bartholomeusz A, Schaefer S. Hepatitis B virus genotypes: comparison of genotyping methods. Rev Med Virol 2004; 14:3–16.

    Article  CAS  Google Scholar 

  2. Stuyver L, De Gendt S, Van Geyt C, Zoulim F, Fried M, Schinazi RF, Rossau R. A new genotype of hepatitis B virus: complete genome and phylogenetic relatedness. J Gen Virol 2000; 81:67–74.

    Article  CAS  Google Scholar 

  3. Pan CQ, Zhang JX. Natural history and clinical consequences of hepatitis B virus infection. Int J Med Sci 2005; 2:36–40.

    Article  Google Scholar 

  4. Chang MH. Hepatitis B virus infection. Semin Fetal Neonatal Med 2007; 12:160–167.

    Article  Google Scholar 

  5. Morgolis HS, Alter MJ, Halder S. Viral hepatitis. In: Evans A, Kaslow R, editors. Viral infections of humans. 4th ed. New York: Plenum; 1997. 363–418.

    Chapter  Google Scholar 

  6. Hou J, Liu Z, Gu F. Epidemiology and prevention of hepatitis B virus infection. Int J Med Sci 2005; 2:50–57.

    Article  Google Scholar 

  7. Lavanchy D. Hepatitis B virus epidemiology, disease burden, treatment, and current and emerging prevention and control measures. J Viral Hepat 2004; 11:97–107.

    Article  CAS  Google Scholar 

  8. Akani CI, Ojule AC, Opurum HC, Ejilemele AA. Sero-prevalence of hepatitis B surface antigen (HBsAg) in pregnant women in Port Harcourt, Nigeria. Niger Postgrad Med J 2005; 12:266–270.

    CAS  PubMed  Google Scholar 

  9. Jammeh S, Tavner F, Watson R, Thomas HC, Karayiannis P. Effect of basal core promoter and pre-core mutations on hepatitis B virus replication. J Gen Virol 2008; 89:901–909.

    Article  CAS  Google Scholar 

  10. Poynard T. Hepatitis C and B: management and treatment. 2nd ed. 2004. 79–156.

  11. Tong MJ, Blatt LM, Kao JH, Cheng JT, Corey WG. Precore/basal core promoter mutants and hepatitis B viral DNA levels as predictors for liver deaths and hepatocellular carcinoma. World J Gastroenterol 2006; 12:6620–6626.

    Article  CAS  Google Scholar 

  12. El-Serag HB, Rudolph KL. Hepatocellular carcinoma: epidemiology and molecular carcinogenesis. Gastroenterology 2007; 132:2557–2576.

    Article  CAS  Google Scholar 

  13. El-Serag HB. Hepatocellular carcinoma. N Engl J Med 2011; 365:1118–1127.

    Article  CAS  Google Scholar 

  14. Liaw YF, Brunetto MR, Hadziyannis S. The natural history of chronic HBV infection and geographical differences. Antivir Ther 2010; 15:25–33.

    Article  Google Scholar 

  15. Kanbay M, Gur G, Akcay A, Selcuk H, Yilmaz U, Arslan H, et al. Is hepatitis C virus positivity a contributing factor to occult hepatitis B virus infection in hemodialysis patients?. Dig Dis Sci 2006; 51:1962–1966.

    Article  Google Scholar 

  16. O’Connell K, Cormican M, Hanahoe B, Smyth B. Prevalence of antenatal hepatitis B virus carriage in the west of Ireland. Ir Med J 2010; 103:91–92.

    PubMed  Google Scholar 

  17. Allwright S, Bradley F, Long J, Barry J, Thornton L, Parry JV. Prevalence of antibodies to hepatitis B, hepatitis C, and HIV and risk factors in Irish prisoners: results of a national cross sectional survey. BMJ 2000; 321:78–82.

    Article  CAS  Google Scholar 

  18. Grogan L, Tiernan M, Geogeghan N, Smyth B, Keenan E. Bloodborne virus infections among drug users in Ireland: a retrospective cross-sectional survey of screening, prevalence, incidence and hepatitis B immunisation uptake. Ir J Med Sci 2005; 174:14–20.

    Article  CAS  Google Scholar 

  19. Tosti ME, McMahon B, van der Sande M, Whittle H, Jan C-F, Poovorawan Y. Viral hepatitis. Viral Hepat 2012; 20:11–12.

    Google Scholar 

  20. Lok AS, McMahon BJ. Chronic hepatitis B. Hepatology 2007; 45:507–539.

    Article  CAS  Google Scholar 

  21. Lin CL, Liao LY, Liu CJ, Chen PJ, Lai MY, Kao JH, Chen DS. Hepatitis B genotypes and precore/basal core promoter mutants in HBeAg-negative chronic hepatitis B. J Gastroenterol 2002; 37:283–287.

    Article  Google Scholar 

  22. Gandhe SS, Chadha MS, Walimbe AM, Arankalle VA. Hepatitis B virus: prevalence of precore/core promoter mutants in different clinical categories of Indian patients. J Viral Hepat 2003; 10:367–382.

    Article  CAS  Google Scholar 

  23. Sitnik R, Pinho JR, Bertolini DA, Bernardini AP, Da Silva LC, Carrilho FJ. Hepatitis B virus genotypes and precore and core mutants in Brazilian patients. J Clin Microbiol 2004; 42:2455–2460.

    Article  CAS  Google Scholar 

  24. Zaky S, Farghaly AM, Rashed HA, Hassan H, Faouzy E, Makhlouf N, Hussein MR. Clinicopathologic features and genotyping of patients with chronic HBV infection in the Upper Egypt. Cell Immunol 2010; 265:97–104.

    Article  CAS  Google Scholar 

  25. Zahran KM, Badary MS, Agban MN, Abdel Aziz NH. Pattern of hepatitis virus infection among pregnant women and their newborns at the Women’s Health Center of Assiut University, Upper Egypt. Int J Gynaecol Obstet 2010; 111:171–174.

    Article  Google Scholar 

  26. Lok AS, McMahon BJ. Chronic hepatitis B: update 2009. Hepatology 2009; 50:661–662.

    Article  Google Scholar 

  27. Chu CJ, Hussain M, Lok AS. Quantitative serum HBV DNA levels during different stages of chronic hepatitis B infection. Hepatology 2002; 36:1408–1415.

    Article  CAS  Google Scholar 

  28. Ledesma MM, Galdame O, Bouzas B, Tadey L, Livellara B, Giuliano S, et al. Characterization of the basal core promoter and precore regions in anti-HBe-positive inactive carriers of hepatitis B virus. Int J Infect Dis 2011; 15:e314–e320.

    Article  CAS  Google Scholar 

  29. Alam S, Ahmad N, Alam K, Mostafa G, Khan M. Correlation between hepatitis B viral DNA load and extent of liver pathology in patients with chronic hepatitis B. Hepat Mon 2008; 8:185–189.

    Google Scholar 

  30. Taghavi SA, Tabibi M, Eshraghian A, Keyvani H, Eshraghian H. Prevalence and clinical significance of hepatitis B Basal core promoter and precore gene mutations in southern Iranian patients. Hepat Mon 2010; 10:294–297.

    PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Khairy H. Morsy MD.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Morsy, K.H., Ghaliony, M.A.A. & ElMel egy, T.T.H. Clinical, laboratory, and virological characteristics of patients with positive hepatitis B surface antigen in Upper Egypt. Egypt J Intern Med 27, 32–37 (2015). https://doi.org/10.4103/1110-7782.155853

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.4103/1110-7782.155853

Keywords

  • egypt
  • hepatitis B surface antigen
  • hepatitis B virus infection
  • PCR
  • risk factors