FREQUENCY OF CHRONIC ACTIVE HEPATITIS IN ASYMPTOMATIC HBV CARRIERS IN BABOL, IRAN

Background- Hepatitis B virus (HBV) infection is a major worldwide health problem. Most of the patients are asymptomatic and at risk of developing chronic liver disease, cirrhosis and hepatocellular carcinoma. The aim of the present study was to determine the frequency of chronic active hepatitis in asymptomatic HBV carriers in Babol, northern Iran. Methods- This study was performed in 410 HBV carriers older than 15 years who were diagnosed by positive serum hepatitis B surface antigen (HBsAg) from January 1998 to September 2000. Family members of infected patients were also screened. For each patient, HBsAg, hepatitis B early antigen (HBeAg), hepatitis B early antibody (HBeAb) and alanine aminotransferase (ALT) were measured at the time of screening and again 6 months later. In patients with raised ALT, liver biopsy was performed and a Knodell score ≥ 4 was considered as chronic active hepatitis. Proportions were then analyzed using the chi-square test. Results- Of the 410 patients, 229 (53.3%) were males and 181 (46.5%) were females. Mean age ± standard deviation (SD) was 28 ± 12.7 years. Of these, 362 (88.3%) were HBeAbpositive and 48 (11.7%) were HBeAg-positive. ALT was elevated in 73 (17.8%) of patients. Chronic active hepatitis was found in 8% and 10.4% of the HBeAb-positive and HBeAgpositive cases, respectively (p = 0.57). Chronic hepatitis was significantly higher in males than females (p = 0.0001) Conclusion- The results show that the frequency of chronic active hepatitis is high in asymptomatic HBV carriers. It is almost equal in HBeAb-positive and HBeAg-positive cases and is higher in males than females. Assessment of HBV precore mutants in anti-HBeAgpositive cases is highly recommended.