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Current characteristics of chronic hepatitis B in Egypt

Abstract

Background and aim

In the era of hepatitis C virus eradication, Egypt had to pay attention to the two million infected with chronic hepatitis B. This study aimed to observe the current characteristics of chronic hepatitis B virus (HBV) infection in Egypt.

Patients and methods

This cross-sectional study was conducted on 183 patients with chronic HBV infection. The demographic, epidemiologic, clinical, laboratory, and treatment data were collected from patient registries.

Results

Positive hepatitis B e-antigen (HBeAg) cases represented 18.04%. They were younger (31.09±8.542–38.22±10.6 years) (P<0.05), with higher alanine aminotransferase (84.91±67.855–53.75±55.575 U/l) (P<0.05) and viral loads (3.58×108±16.49×108–1.74×106±10.1×106 IU/ml) (P<0.05), particularly in chronic active carrier states. Unsafe hygienic procedures (sharing toothbrushes and razors) were the main infective routes (73.7%). Coinfection with hepatitis C virus was documented in 14.7%, along with 16.3% with schistosomal infestation. HBV and hepatitis D virus coinfection was reported in 8.9% of the studied cohort. Radiologically, liver cirrhosis was detected in 44% of cases, with associated splenomegaly in 20.7%. Histologically, 40.2% were found to have significant pathology (A2, F2>2). Thirty (16.3%) cases were outside international guidelines of treatment, only for follow-up. Overall, 70.5% were subjected to lamidine therapy, with unfair responses mainly detected in the HBeAg-positive group (71.4%), who responded marvelously to interferon finite regimens. HBeAg-positive status and schistosomiasis were found to be associated with poor response to oral antivirals by multivariate analysis (P<0.05).

Conclusion

More classified governmental censorship efforts, notably on private organizations, along with awareness levitation are promptly mandated. Additionally, the poor response to oral antivirals in HBeAg-positive patients signifies sticking to interferon as a first-line treatment option.

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Correspondence to Maha M. Elsabaawy PhD.

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Elsabaawy, M.M., Elsherefy, M.E., Sakr, H.E. et al. Current characteristics of chronic hepatitis B in Egypt. Egypt J Intern Med 31, 822–830 (2019). https://doi.org/10.4103/ejim.ejim_70_19

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