e-antigen-negative chronic hepatitis B in Bangladesh.
BACKGROUND
Bangladesh is a densely populated country where about 10 million people are chronically infected with hepatitis B virus (HBV). The aim of the present study was to evaluate the biochemical, virological and histological characteristics of HBeAg-negative chronic hepatitis B (CHB).


METHODS
Patients were included in this study if they were chronically infected with HBV with detectable DNA. The patients who were co-infected with human immunodeficiency virus, hepatitis delta virus or hepatitis C virus, and previously subjected to antiviral treatment, and those with hepatocellular carcinoma were excluded. The study was conducted during the period of January 2001 to December 2007. During this period 2617 patients with CHB were studied. HBeAg-positive cases were included to compare the characteristics. Among them, 237 cases underwent liver biopsy.


RESULTS
2296 patients (87.7%) were male, with a mean age of 28.9+/-13.7 years. 2375 patients (90.8%) had CHB, and 242 (9.2%) were cirrhotic. HBV DNA levels were 7.6+/-1.5 copies/ml, ALT was 111.3+/-212.5 U/L, and AST was 91.5+/-148.9 U/L. The number of HBeAg-negative CHB cases was 1039 (39.7%). HBeAg-negative patients with a lower DNA load were older, and they had more fibrotic changes in the liver than HBeAg-positive patients. The two groups did not differ in necroinflammatory activity, but the former had lower ALT and AST values. Cirrhosis was more common in e-antigen-negative patients.


CONCLUSIONS
e-antigen-negative CHB patients are older and have more hepatic fibrosis patients than HBeAg-positive patients, although they have similar necroinflammatory activity.
Ahmad
Nooruddin
N
Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka, Bangladesh.
Alam
Shahinul
S
Mustafa
Golam
G
Adnan
Abul Barkat Muhammad
AB
Baig
Rahat Hasan
RH
Khan
Mobin
M
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D001459:Bangladesh; D002648:Child; D002675:Child, Preschool; D004279:DNA, Viral / Q000097:blood; D005260:Female; D006513:Hepatitis B e Antigens / Q000097:blood*; D006515:Hepatitis B virus / Q000235:genetics / Q000276:immunology*; D019694:Hepatitis B, Chronic / Q000150:complications / Q000201:enzymology / Q000235:genetics / Q000276:immunology*; D006801:Humans; D007223:Infant; D008103:Liver Cirrhosis / Q000201:enzymology / Q000821:virology*; D008297:Male; D008875:Middle Aged; D019562:Viral Load; D055815:Young Adult
D004279:DNA, Viral; D006513:Hepatitis B e Antigens; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase