High prevalence of alpha 1 antitrypsin phenotypes in viral hepatitis B infected patients in Iran.
OBJECTIVE
Hepatitis B virus (HBV) infection is a major global public health problem. Approximately 2 billion people are infected worldwide and more than 350 million of these individuals are chronic carriers of HBV. Approximately 15-40% of infected patients will develop cirrhosis, liver failure, or hepatocellular carcinoma (HCC). Alpha 1 antitrypsin (AAT) deficiency is one of many factors that may be involved in abnormalities such as liver and lung disease, inflammatory joint diseases, and inflammatory eye diseases. In the present study, the role played by AAT in HBV infected individuals is analyzed.


METHODS
AAT phenotyping and trypsin inhibitory capacity (TIC) experiments were performed on 281 HBV infected patients who were referred to Tehran and Zahedan Hepatitis Center for a period of 3 years from June 2001 to September 2003. The same tests were performed on 257 individuals who did not suffer from any systemic diseases (control group). The case group was subdivided into three groups: carrier (36.7%), chronic (50.5%), and cirrhotic (12.8%).


RESULTS
The results showed that AAT phenotypes, MS, MZ, M(1)Z, and M(1)S, were significantly higher in the HBV group (p<0.01). In addition, there was a significant difference in AAT phenotypes (MS, MZ, and M(1)Z) among inactive carriers and individuals in the chronic and cirrhotic group (p<0.001).


CONCLUSIONS
There is a high prevalence of moderate AAT (MS, M(1)S, and MV) and severely deficient (MZ and M(1)Z) phenotypes in Iranian HBV individuals. In addition, AAT deficiency might be a risk factor for infected HBV individuals progressing from the carrier stage to chronic and cirrhotic stages.
Hashemi
Mohammad
M
Department of Clinical Biochemistry, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran.
Alavian
Seyed Moayed
SM
Ghavami
Saeid
S
de Serres
Frederick J
FJ
Salehi
Masoud
M
Doroudi
Taher
T
Fard
Amir Hossain Mahagheghi
AH
Mehrabifar
Hamid
H
Milani
Behzad
B
Shahri
Seyed Javad Saeidi
SJ