[Chronic HBS antigen carriers casually discovered - evolutionary aspects about 221 adults]

ABSTRACT

Hepatitis B virus infection constitutes a health public problem notably in our country where the frequency of chronic HBs antigen carriage is about 5%. Most of these patients are asymptomatic and so underestimated. Study epidemiological characters and clinical, biological and virological profile of chronic HBs Ag carriers whose discovery was fortuitous. retrospective study of 221 patient's files where HBs Ag was casually discovered blood donors [128], pregnant women [40], exposition to risk factor [24], familial inquiry [23] and prenuptial examination [6]. average age was 31 years with a male predominance. Among the hepatitis risk factors found high frequency of multiple syringes use and scarifications. All patients were asymptomatic with a normal physical exam. Prevalence of anti-HCV antibodies was 0,28% and that of anti-HDV 9,3%. A moderate cytolysis was noted in 14 patients [6,3%] and about 2/3 of them had positive markers of viral replication [HBe Ag+ and/or DNA+]. HBe antigen was positive in 12,7% of cases. Average duration of follow-up was 20,7 months. Three patients made spontaneous conversion HBe Ag/anti-HBe, and one conversion HBs Ag/anti-HBs. Hepatic biopsy was practised in 8 patients with cytolysis and showed 3 cirrhosis and 5 chronic hepatitis. Conclusion: despite favorable evolution of these patients, a clinical and biological supervision is necessary to search cytolysis and/or viral replication requiring then more agressive management