Comparative Study of the Degree of Severity of Hepatitis B in Preicteric, Icteric and Posticteric Hbsag Seropositive Patients Using ALT, AST, Cu, Fe, Mn, Se, Mg, Zn and Albumin

Abstract

Jaundice is the yellowish pigmentation of sclera of eye, skin and body fluids. It is associated with hepatitis Bvirus infection due to the destruction of the infected hepatocytes and intrahepatic-cholestasis caused by the scarsof the healed hepatocytes. Hepatitis B patients that have never had jaundice are referred to as preicteric patients,while those that have recovered from jaundice are referred to as posticteric hepatitis patients. Those onessuffering from jaundice are referred to as icteric patients. This research work was designed to determine andcompare the severity of hepatitis B using the serum levels of liver enzyme, albumin and micronutrients inHBsAg seropositive patients. One hundred and fifty HBsAg seropositive critically ill rural patients of theAtisbo/Saki-East/Saki-West federal constituency aged 5- 79 years; (75 females: 75males) classified intopre-icteric, icteric and posticteric patients were successfully monitored and investigated. One hundred and twelveHBsAg seronegative and HBV non-infected apparently healthy volunteers from the same community aged 4-80years were studied as normal control volunteers. Forty three HBsAg seropositive patients were recruited fromIbadan as urban reference. The presence of hepatitis B surface antigen (HBsAg) and envelope antibodies tohepatitis B, (anti-HBe) were determined in the test and control subjects serologically (ELIZA). Similarly, theserum levels of liver enzymes Alanine-aminotransferase (ALT), and Aspartate-aminotransferase (AST) andmicronutrients (Cu, Zn, Fe, Mn, Mg and Se) were biochemically (spectrophotometry and atomic absorptionspectrophotometry) determined. Liver enzymes and albumin assays were routinely employed to recruit HBsAgseropositive patients in active liver destruction. Antibody to envelope antigen was used to detect patients that areinfected but have been cleared of the antigens(HBsAg and HBeAg). The results obtained showed a significantlyhigher mean serum values of AST,ALT,Fe,Cu and Mn with a significantly lower serum albumin, Se,Mg,and Znlevels in patients compared with the results obtained from the controls during the 1st bleeding with P