title: Molecular and serological assessment of chronic HBV carriers and additional burden of applying updated guidelines in Pakistan.
abstract: OBJECTIVE
  To assess the additional burden of the patients eligible for treatment, based on recommendations on viral load, in the light of 2009 version of AASLD guidelines, as compared to 2004 guidelines and to determine the frequency of HBeAg in chronic HBV carriers.
  
  
  METHODS
  Descriptive cross-sectional study.
  
  
  METHODS
  Virology Department, Armed Forces Institute of Pathology, Rawalpindi, from November 2010 to January 2012.
  
  
  METHODS
  Persons with chronic HBV infection, reporting for HBV DNA PCR test, were included in the study and blood samples were collected. HBV DNA load was determined by Real Time PCR. HBsAg and HBeAg were tested by ELISA.
  
  
  RESULTS
  Out of the 801 subjects positive for HBsAg, 74 (9.24%) were positive for HBeAg. Out of them, 113 (14.1%) had HBV DNA load > 100,000 copies/ml and were eligible for treatment according to AASLD 2004 guidelines. Forty one (5.1%) had HBV load between 10,000 and 100,000 copies/ml, and were additionally eligible for treatment as per AASLD 2009 guidelines. The 5.1% of 4.5 million estimated HBV carries in Pakistan comes to 229500.
  
  
  CONCLUSIONS
  There was a low HBeAg positivity and HBV DNA positivity in our chronic HBV infected persons. Moreover, there is an increase of 229500 potential candidates for HBV treatment in Pakistan based on viral load testing, according to the AASLD 2009 guidelines when compared with 2004 guidelines. The increase in the number of candidates for treatment may require an additional expenditure of tens of billions of rupees.
authors.affiliation: Department of Virology , Armed Forces Institute of Pathology (AFIP), Rawalpindi.
authors.forename: Agha Babar
authors.initials: AB
authors.lastname: Hussain
authors.affiliation: Vice Chancellor, Baqai Medical University, Karachi.
authors.forename: Syed Azhar
authors.initials: SA
authors.lastname: Ahmed
authors.affiliation: Department of Chemical Pathology, Armed Forces Institute of Pathology (AFIP), Rawalpindi.
authors.forename: Farooq Ahmad
authors.initials: FA
authors.lastname: Khan
authors.affiliation: Department of Virology , Armed Forces Institute of Pathology (AFIP), Rawalpindi.
authors.forename: Eijaz
authors.initials: E
authors.lastname: Ghani
authors.affiliation: Department of Virology , Armed Forces Institute of Pathology (AFIP), Rawalpindi.
authors.forename: Muhammad Ali
authors.initials: MA
authors.lastname: Rathore
authors.affiliation: Department of Haematology, Armed Forces Institute of Pathology (AFIP), Rawalpindi.
authors.forename: Nadir
authors.initials: N
authors.lastname: Ali
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000410:Alanine Transaminase / Q000097:blood; D000998:Antiviral Agents / Q000627:therapeutic use; D002353:Carrier State / Q000821:virology*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004279:DNA, Viral / Q000097:blood*; D005260:Female; D006514:Hepatitis B Surface Antigens / Q000097:blood*; D006513:Hepatitis B e Antigens / Q000097:blood*; D006515:Hepatitis B virus / Q000235:genetics* / Q000302:isolation & purification; D019694:Hepatitis B, Chronic / Q000097:blood* / Q000188:drug therapy / Q000821:virology; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D010154:Pakistan; D016133:Polymerase Chain Reaction; D017410:Practice Guidelines as Topic; D011237:Predictive Value of Tests; D019562:Viral Load; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens; D000410:Alanine Transaminase