Frequency of HBeAg Negative-Chronic Hepatitis B in Hamadan (April 2001-September 2002)

Infection due to hepatitis B virus (HBV) could be due to wild or mutant viruses. The HBeAg negative chronic hepatitis B (HbeAg-CHB) is unable to produce hepatitis B, e antigen (HbeAg), so that patients with this varient do not present with HBV characterized by HbcAg in the serum. HbeAg-CHB usually proceeds to serious liver disease. The prevalence of different viral forms in patients with chronic liver disease in Iran has not been established.

Seventy-six Hamadanian patients with over 6 months HBSAg positivity were enrolled. Patients with co-infection of HIV, HCV, past history of alcoholism, fatty liver, using of hepatotoxic drugs, autoimmune hepatitis and other metabolic liver disease were excluded. All patients were screened for Hhe Ag. HbeAb. HBV DNA by PCR, AST, ALT, ALK. pH and bilirubin.

Eleven (14.5%) patients had HheAg-CHB (HbsAg +ve, HbeAg-ve / ve/anti HbeAb + ve, HBV DNA + ve and elevated AST, ALT) and 6 (8%) had normal transminases (AST and ALT) accompanied by the remaining criteria of HbeAg-CHB. 59 patients (77.5%) were infected with wild type HBV, ie: HBSAg + ve, HbeAg-ve, HbeAb + ve, HBV DNA- ve, and normal AST, ALT.

Frequency of HbeAg.CHB in Hamadan is 14.5% knowing of this varient of chronic hepatitis B is important since the HbeAg-CHB have worse prognosis than wild type and more better response to lamivudine than interferon.