Frequency of hepatitis B envelope antigen-negative chronic hepatitis B virus infection in untreated patients from three cities in Pakistan

Abstract

Background: Hepatitis B envelope antigen (HBeAg)-negative chronic hepatitis B virus (CHB) infection is a clinical entity refractory to treatment and has implications for disease outcome. Objectives: To determine the frequency of HBeAg-negative CHB in untreated hepatitis B surface antigen (HBsAg)-positive patients. Methods: We conducted this cross-sectional study of untreated HBsAg-positive patients from 3 cities in Pakistan for more than 6 months. Results: Of 495 patients, 276 (47.7%) had detectable hepatitis B virus (HBV) DNA (mean 5.3 ± 1.96 log10 copies/mL), 81 (16.4%) were HBeAg positive and 414 (83.6%) were HBeAg negative. All 81 (100%) HBeAg-positive patients had detectable HBV DNA. Frequency of HBeAg-negative CHB infection was 155 (31.3%) among HBsAg-positive patients. One hundred and sixteen (74.8%) of the HBeAg-negative patients with CHB infection were in the age range of 15?35 years. Conclusions: HBeAg-negative patients constitute a considerable proportion of patients with CHB infection. HBsAg-positive patients, especially with younger age, should be thoroughly investigated for this entity to avoid the devastating long-term complications of this disease. Keywords: Chronic hepatitis B, hepatitis, hepatitis B surface antigen, Pakistan