Demographics of incidentally diagnosed chronic hepatitis B in teenagers in Bangladesh

Document Type : Original article

Authors

1 Sir Salimullah Medical College Mitford Hospital, Dhaka, Bangladesh

2 Hepatology dept., Bangabandhu Sheikh Mujib Medical Univ., Dhaka, Bangladesh

3 Hepatology dept., Dhaka Medical College Mitford Hospital, Dhaka, Bangladesh

4 Statistics dept., Dhaka Univ., Dhaka, Bangladesh

Abstract

Hepatitis B (HBV) is endemic in Bangladesh. A prevalence of 2.4-9.7 % in adult population has been documented in various studies. The magnitude of HBV infection among Bangladeshi children and adolescents is less known.
Chronic hepatitis B (CHB) in teenagers commonly present with Immune tolerant phase. Subsets of these patients present in Immune clearance, Inactive carrier or Reactivation phase. However both Immune tolerant and Reactivation phase need evaluation in decision making during treatment. Teenagers between 13-19 year presenting with incidental diagnosis of HBsAg positivity with either HBeAg positive or negative chronic hepatitis B, with normal or minimally raised aminotransferase level with low or high HBV DNA were included in this study. This was a prospective randomized study.
CHB patients were divided into two groups, Group A which was HBeAg positive (Immune tolerant) and Group B was HBeAg negative (Reactivation phase). All 21 patients were asymptomatic. 11 patients with HBeAg positivity
(M:F = 10:1), 10 patients with HBeAg negativity (M:F = 7:1). ALT range in HBeAg positive population was 15-77 U/L (Mean 45.8 U/L), in HBeAg negative population was 16-46 U/L (Mean 30.6 U/L). HBV DNA level in HBeAg positive patients was 105 -1012, mean 1010, in HBeAg negative patients was 103 -107, mean 106, However HBV DNA was mostly low in HBeAg negative variety. Necro-inflammation 7 and above was present in 8 patients (72.72 %) in group A, 7 patients (70 %) in group B. Stage 3 fibrosis (F3)was present in 1 patient (9 %) in group A, 1 patient (10 %) in group B presenting
with similar histologic activity index and fibrosis scores in both groups. Teenagers with chronic Hepatitis B are potential treatment candidates. So demographic studies with histologic scoring is needed as a guide to start treatment. Present study reveals presence of Group B (HBeAg negative) variant in teenagers. As compared to adult population Group B in teenagers presents with relatively benign disease in those having normal or minimally raised alanine aminotransferase levels. 

Keywords

Files

Share

How to cite

Statistics