Serological markers hbsag and hbeag in chronic hepatitis B carriers and their correlation with viral DNA by polymerase chain reaction

Abstract

Hepatitis B is the most widespread and important type of viral hepatitis which may become chronic and lead to complications like cirrhosis and hepatocellular carcinoma. India is an intermediate group (4-7%) among carriers with about 45 million infected individuals. This study was undertaken to assess serological markers Hbsag and Hbeag in chronic carriers of Hepatitis B virus infection and compare with viral load as determined by PCR. A cross-sectional study was conducted with 30 patients (Hbsag positive status for at least 6 months) attending the OPD and IPD of Shri BM Patil Medical College. 5 ml blood was drawn with full aseptic precautions from the patients after detailed history and written consent. Hbsag by ELISA was done for confirming the carrier status and then, serum was sent for Hbeag detection by chemiluminescence immunoassay and for assessment of hepatitis B viral DNA by Real-Time Polymerase Chain Reaction Assay. Majority of patients (46.7%) belonged to age-group 20-30 years. Therapeutic injections (36.7%) were the most common risk factor. All 30 cases were positive for Hbsag. Majority (63.3%) had HBV DNA below detectable levels while 10% were super carriers (>20,000 IU/ml). Hbeag positivity was seen in 23.3% patients. HBV DNA was detectable in all of these cases ranging from 66 IU/ml to 64,291,972 IU/ml. (log 107) Viral DNA levels were negative in 83% of the patients who were negative for Hbeag. Remaining 17% had detectable HBV DNA levels ranging from 50 IU/ML to 5544 IU/ml (log 103). Majority (63.3%) were chronic inactive carriers who may have total HBsAg clearance later. 20% were super carriers who are known to be highly infectious.