Risk factors of transmission and natural history of chronic hepatitis B infection in Iranian patients

To investigate routes of transmission, demographic characteristics and frequency of different phases of chronic hepatitis B (CHB) in 2000 Iranian patients.

Knowledge about the most frequent risk factors of CHB and its different phases is very important for optimal prevention and management policy making.

In this cross-sectional study, 2000 HBsAg positive patients who were referred to Taleghani Hospital from 2011 through 2018 were enrolled. ELISA method was employed to detect serological markers of CHB. Taking into account the HBV DNA and ALT levels and HBeAg status, patients were classified in four groups, according to AASLD 2017 guideline.

Male and female patients had nearly equal frequencies in our study and 82.5 % of them aged more than 20 years. A great number of our patients (95%) were HBeAg negative and the most frequent risk factors of HBV infection were positive periodontal and family history (40.3% and 24.9%, respectively). Majority of our patients were inactive carriers (63.35%) while minority of them were in immune tolerant group (2.15 %).

Immune tolerance phase group had lowest members in our study and most of them were above 20 years old.This can be due to the mass vaccination of neonates since 1993. Most of CHB patients were in inactive carrier group. Although it is recommended not to treat these patients, but performing periodic liver function tests and disease severity assesment is warranted, especially in patients above 40 years old.