ABSTRACT
Background: Although chronic hepatitis B virus infections are common in Egypt, the incidentally discovered asymptomatic forms are very frequent. Their serological profile and clinical significance have not been determined
Aim: to characterize the clinical, serological and histological liver damage among incidentally detected asymptomatic hepatitis B surface antigen [HBsAg]-positive subjects [IDAHS] in Egypt
Methods: we prospectively studied 70 consecutive IDAHS patients who were long term HBsAg carriers. Tests for liver function, serological markers for HBV, HCV, HDV and schistosomiasis were done for all patients. HBV DNA was determined by the branched DNA technique and PCR at the core promotor/precore region and the S region. Liver biopsy specimens from 44 patients were studied and scored for activity and fibrosis stage by modified Knodell score and the METAVIR score. HBsAg and HBcAg were immunohistochemically evaluated in the liver tissue
Results: of the studied 70 patients, 57 [81.6%] were HBeAg negative and 13 [18.4%] were HBeAg positive. There was statistically significantly elevated hepatic transaminases in HBeAg-positive patients when compared to HBeAg-negative patients. HBV DNA was detected in only 3% of patients by the b-DNA technique and in 97% by the PCR techniques. Coinfection with HDV was found in 4.2% of patients. Pathological examination of liver tissue revealed mild activity in 21 [47.7%] of patients. Also, 21 patients [47.7%] revealed mild to moderate expansion of portal areas while 7 patients [15.9%] showed bridging fibrosis and no patient was cirrhotic
Conclusion: among 1DAHS sub jects, the majority are HBeAg negative without elevation of hepatic transaminases. They should be considered patients since viremia is detected in almost all cases using PCR technique, and histopathological evidence of chronic hepatitis B virus infection and liver damage is noted in varying degrees