Prevalence of the Hepatitis B “e” Antigen in Nigerian Patients with Chronic Liver Disease
Background: In Chronic Hepatitis B liver disease [CHB] the presence of the “e” antigen [HBeAg] is thought to be associated with active virus replication and increased risk of severe liver disease. Its absence is thought to characterize inactive disease associated with suppressed viral replication, normal liver enzymes, and improved clinical outcomes. Methodology: 163 patients with a clinical, ultrasound and/or histological evidence of liver cirrhosis or HCC were evaluated. The hepatitis B virus antigens [HBsAg and HBeAg] and serum alanine aminotransferase [ALT] were determined as an indicator of chronic HBV infection, active viral replication and underlying hepatic inflammation respectively. Results: 84/163 [52%] were GBsAg positive of which [10/84] 11.9% were HBeAg positive. Significant ALT elevation was seen in most patients with liver cirrhosis and HCC and was seen in both “e” antigen positive [80%] and negative [60%] patients [p=0.2]. Conclusion: Chronic hepatitis B liver disease [CHB] associated with “e” negative HBV infection appears to be the predominant presentation of liver cirrhosis and hepatocellular carcinoma. Contrary to common expectations, HBeAg negative infections are associated with severe ongoing hepatic inflammation and cause severe liver disease comparable with HB e positive disease.
NQJHM Vol. 14 (1) 2004: pp. 1-4