Changing trends of Hepatitis B seromarkers amongst Pakistani population: a laboratory-based review

Objective: To study the changing trends of hepatitis B markers tested at Aga Khan University Hospital clinical laboratory according to the internationally recognised classification of hepatitis B profile. Methods: The retrospective study involved analysis of laboratory records of hepatitis B profiles of all patients collected from January 2001 to December 2008 at the Aga Khan University Hospital s clinical laboratory. Patients with complete profile tested were categorised according to the Centre for Diseases Control classification of hepatitisB profile. SPSS 16 was used for statistical analysis. Results: A total of 185,825 patients had serological markers for hepatitis B tested. Mean-age of reactive hepatitis B surface antigen (HBsAg) patients was 30±12.5 years. HBsAg reactivity was significantly higher in males than females (34% vs 12%; p 0.0001). HBsAg showed a slight decline in the percentage reactivity during the 8-year study period, while a gradual increase in hepatitis B surface antibody (HBsAb) reactivity was observed. Of the total, 23% patients belonged to the susceptible to infection category; 39% patients were classified as chronically-ill ; 12% patientswere categorised as immune due to hepatitis B vaccination . 3% patients were classed as acutely infected . Overall, samples received from Peshawar, Quetta and Larkana showed very high reactivity rates. Conclusion: The study substantiated the general perception that levels of HBsAg is showing a decreasing trend, while levels of HBsAb are increasing perhaps due to better vaccination of population.