Impact of 10 years of hepatitis B vaccination on the frequency of acute symptomatic hepatitis B at a major urban referral center in Egypt

This study aimed to determine the impact of 10 years of universal hepatitis B immunization on the prevalence of acute symptomatic viral hepatitis B in Egypt compared with previous results reported by the same authors in 1983. Two hundred consecutive patients with acute symptomatic viral hepatitis, diagnosed clinically and biochemically, were enrolled from Embaba Fever Hospital [EFH], Giza Governorate, Egypt in the period from December 2001 to September 2002. Serological tests were done using ABBOTT AXSYM [Abbott laboratory, Abbott Park, III] for hepatitis A virus [anti-HAV IgM], hepatitis B virus [HBsAg, anti-HBc total and IgM, anti HBs], hepatitis C virus [anti-HCV IgM and total, in addition to PCR], hepatitis D virus [anti-HDV IgM] and hepatitis E [anti-HEV IgM]. In addition, the patients were screened for IgM Ab of cytomegalovirus [CMV], Ebstein barr virus [EBV] and PCR for HGV and transfusion transmitted virus [TTV]. In the present study, the overall acute HBV infection was accounted for 31.5% of the acute viral hepatitis cases, with a male predominance of 62.4% and a significant increased prevalence in adolescent and adults. Although the clinical presentation of HBV did not differ from those of the various causes of hepatitis, the mean ALT levels were significantly higher in acute HBV when compared with acute HAV infection. The frequency of acute hepatitis B was decreased from 43.4% in 1983 to 31.5% in 2002, which was particularly evident in children and there were no significant changes in the rate of acute hepatitis among HBsAg carriers [12.3% and 9%, respectively]. Despite the lower coverage rate of hepatitis vaccination in those <9 years [37.9%], there was virtual absence of acute hepatitis B. The use of multiple seromarkers decreased the prevalence of the undiagnosed cases in those suffering from acute hepatitis to 6.5%

Hepatology in Egypt 20 years ago - changing pattren of schistosomiasis in Egypt 1935-79

A village in the Nile delta surveyed for sci istosmiasis by J.A. Scott in 1935 was surveyed again in 1979. The same number of people as in the 1935 survey were randomly selected for investigation by the same parasitological techniques as those used by Scott. The prevalence of Schistosoma mansoni infection had increased from 3.2% to 73%, whereas S.haematobium infection, which had been very common in 1935 [74%], had almost disappeared [2.2%].in the local district hospital since 1972 the percentage of urine specimens found to contain S. haematobium ova has dropped from 30 to 9%, while the percentage of stool specimens containing S.mansoni ova has increased from 2 to 22%. In the local irrigation canals snail intermediate hosts for S.mansoni have outnumbered those for S.haematobium by a factor of 5-40 in the past 7 years. Changes in the proportions of snail vectors appear to be related to construction of the Aswan High Dam and to changes in the water - flow patterns of the Nile. The change in the relative frequencies of the two infections has important public - health implications, since the hepatosplenic schistosorniasis caused by S.mansoni is more difficult to treat and is associated with more morbidity and mortality than the urinary schistosmiasis caused by S.haematobium

Frequency of HBV variants among Egyptian patients with acute and chronic liver disease

In this work 94 Egyptian patients [54 patients with chronic liver disease and 40 with acute hepatitis] were studied by clinical, biochemical, parasitological, and serological methods. Histopathological study of the liver was done for 35 out of the first group. The aim of this work is to study the frequency of HBV variants in Egypt, and their effects on the liver. The following results were obtained: A- In the group of chronic liver disease: - Five out of 22 HBsAg positive patients [22.7 percent] were having wild HBV infection. Ten of the 22 patients [45.5 percent] had HBV mutant infection. HBV DNA was positive in 4/32 [12.5 percent] of HBsAg negative patients. Liver enzymes and bilirubin were significantly higher in HBV DNA positive patients than in the negative ones. No statistically significant differences were found in histopathological lesions in the HBV DNA positive group compared to the HBV DNA negative group. B. In the group of acute hepatitis HBV DNA was positive in ten out of 17 HBsAg +ve patients [58.8 percent], out of these ten patients six [60 percent] were having the mutant virus. AST and ALT were significantly higher in the last six patients [mutant] than in the other cases of acute hepatitis