Acute hepatitis B in adults 5-years experience

ABSTRACT

Total 946 patients were HBs Ag positive, out of 1325 patients admitted with Acute Viral Hepatitis, in Medical Unit II, Nishtar Hospital, Multan during Jan. 1987 to Dec. 1991, with an incidence of 71.4%. There were 632 males [66.8%] and 314 females [32.2%] patients. Mean age was 40.73 +/- 15.49 years, with male of slightly older age than female patients [41.29 +/- 15.50 and 38.93 +/- 15.68 years]. Clinical and laboratory features were unable to differentiate between HbsAg positive and negative patients. Serum bilirubin [7.31 +/- 5.71 V 6.77 +/- 5.00] SGPT [285.51 +/- 203.97 V 263.11 +/- 202.55], serum alkaline phosphatase [262.37 +/- 167.06 V 244.39 +/- 149.55] and fasting blood sugar [100.35 +/- 56.09 V 95.09 +/- 35.09] were slightly higher in HbsAg positive as compared to HbsAg negative patients. Various complications noted like bleeding [P<0.0001] ascites [P<0.0001 in males P<0.001 in females], hepatorenal syndrome [P<0.001] in males and deaths [P<0.0001 in females] were significantly more common in HbsAg positive patients. Hepatic encephalopathy was more common in female patients [P<0.01] only. Similarly extremes of ages, high temperature, small liver, very high s. bilirubin and enzymes, hypoglycemia, hypokalemia and prolonged prothrombin time [P<0.01 to <0.0001] were commonly seen in female patients. While high temperature, high serum enzymes hypokalemia and prolonged prothrombin time [P<0.01 to P<0.0001] were more common in male HbsAg positive patients. There were total 19.13% deaths, while in male patients death rate was 22.15% and in female HbsAg positive patients deaths were 13.05%. Excluding patients with hepatic encephalopathy, total death rate was just 3.80% and in male HbsAg positive patients death rate was 6.22%. There was no death in female HbsAg positive non-comatosed patients. Overall death rate was higher in HbsAg negative [30.34%] patients as compared to HBs Ag positive [19.13%] patients