Seropositivity of hepatitis delta virus in patients with chronic Hepatitis B virus infection

To determine the frequency of hepatitis delta virus [HDV] seropositivity in patients with chronic Hepatitis B Virus [HBV] infection at Armed Forces Institute of Pathology [AFIP], Rawalpindi. Study design: Cross-sectional study. The study was conducted at department of Virology, AFIP, Rawalpindi. A total of 227 serum samples were collected at AFIP, Rawalpindi, from patients with chronic hepatitis B virus [HBV] infection along with a short history regarding the age, sex and socioeconomic status. Enzyme Linked Immundsorbent Assay [ELISA] for detection of HDV Immunoglobulin G [IgG] and Immunoglobulin M [IgM] antibodies was performed on all the collected serum samples. A total of 30 [13.2%] patients out of 227, were found positive for IgG. The mean age of the patients was 35.8 +/- 10.7 years. Seropositivity of HDV-IgG was 12.8% [25/195] in males and 15.6% [5/32] in females. 11.8% [6/51] of patients from higher socioeconomic group and 13.6% [24/176] in lower socioeconomic group were positive for HDV-IgG [p=0.728%]. Our study shows that 13.2% of chronic hepatitis B virus infected patients at AFIP, Rawalpindi, were positive for HDV IgG. HDV seropositivity was not affected by demographic variables-such as age, gender and socioeconomic status of patients

Hepatitis B viral load in various categories of chronic hepatitis B carriers

To determine serum hepatitis B virus [HBV] DNA levels by Real-time Polymerase chain reaction [PCR] in different categories of treatment-naive patients with chronic HBV infection in context with Hepatitis B serology and serum Alanine aminotransferase [ALT] levels. Cross-sectional study. A total of 122 chronic hepatitis B carriers, including 79 low grade carriers [Anti-HBe positive HBeAg negative], 40 high grade carriers [HBeAg positive, Anti-HBe negative] and 3 intermediate grade carriers [Both HBeAg and Anti-HBe negative] were evaluated for HBV DNA levels and serum ALT levels. The serum HBV DNA levels of the low grade carriers with normal ALT levels [<40 IU/L] were significantly lower than the low-grade carriers with raised ALT levels [mean viral load 3x10[3] vs. 1.6x10[6] copies/mL; p=0.0003]. The HBV DNA levels of the high grade carriers were significantly higher than those of the low grade carriers with normal ALT levels [mean viral load 6.4x10[7]vs. 3x10[3] copies/mL; p=0.0007] and than those of low grade carriers with raised ALT levels [mean viral load 6.4x10[7] vs. 1.6x10[6] copies/ mL; p=0.03]. The results show that HBV DNA levels vary in different categories of chronic hepatitis B carriers and when evaluated by a sensitive quantitative PCR assay the HBV DNA levels can be used for differentiation between HBeAg-negative chronic hepatitis B and inactive hepatitis B surface antigen carrier state

Correlation of viremia and alanine aminotransferase in sera of HCV infected patients

A descriptive, semi-interventional and analytical study was planned to evaluate the usefulness of serum alanine aminotransferase [ALT] testing as compared with Hepatitis C Virus [HCV] RNA testing by Polymerase Chain Reaction [PCR] in different clinical settings of HCV infection. The study was carried out from Dec 2003 to Feb 2004 at Virology department, Armed Forces Institute of Pathology, Rawalpindi. The patients referred to AFIP for blood test for Hepatitis C Virus RNA by PCR were included in the study. The demographic information like age and sex of the patient was noted down. Blood samples were collected and sera were separated. Two hundred and fifty microlitres [ul] of serum was transferred to plastic aliquots that were stored at -80°C in a retrievable fashion until utilized for HCV RNA. The remaining part of serum was stored at -20°C until tested for ALT level. The HCV RNA test was carried out with a commercial kit [Acugen, USA] using automated equipment [Robomaster] based on Real Time PCR. The serum ALT was evaluated with commercial kit of GPT [ALT] IFCC mod. liq UV Humazyme Test [Human-Germany]. Out of the 199 cases, 135 [67.8%] had detectable HCV and thus declared positive for PCR while the remaining 64 had no detectable virus in their sera and were called negative for HCV RNA PCR. ALT was raised in 133/135 [98.5%] PCR positive patients and 08/56[14.2%] PCR negative patients. It is concluded that raised ALT level has good sensitivity in predicting the positivity for HCV RNA in sera of HCV infected individuals and, therefore, can be used with a fair degree of confidence for assessment of degree of liver damage in HCV infected individuals without cirrhosis and hepatocellular carcinoma