ABSTRACT
Objective:
To assess the grade of underlying liver disease in incidentally detected asymptomatic HBsAg positive subjects (IDAHS).
Materials and Methods:
We examined 267 IDAHS (preoperative, pregnancy, blood donor, family and premarital screenings, check-up.. ). The patients whose HBsAg positivity and biochemical parameters studied together were excluded. Clinical, biochemical, virological and histological assessments were performed.
Results:
One hundred and ninety two (71.9%) of the patients were male and 75(28.1%) of them were female. Two hundred and forty five (92.1%) subjects were HBeAg negative and 21 (7.9%) were HBeAg positive. HBV-DNA levels were <2000 IU/ml in 57.3% of the patients whereas 42.7% of them had a HBV-DNA level of ≥2000 IU/mL. Thirty four of 49 patients having biopsy had significant fibrosis (F≥2) and 11 of patients had a histological activity index of ≥8. Taking into account all patients with and without biopsy 37 of them took diagnosis of therapy indicated chronic hepatitis B (8 of them were cirrhosis). One hundred and fifty eight (59,1%) and seven patients were diagnosed as inactive carriers and immuntolerant respectively. One of the cirrhotic patients had hepatocellular carcinoma. Forty six cases who were diagnosed neither as CHB nor as inactive carrier (with HBV-DNA level ≥2000 IU/ml and normal ALT) were planned to be followed up.
Conclusion:
Taking into account the heterogenicity and distribution of the patients having biopsy according to their ALT and HBV-DNA levels; if we could have made biopsy for all of the 113 patients (55 with biopsy, 58 without biopsy) at least a quarter of patients could have taken diagnosis of CHB and more than half of the patients could be categorized as inactive carrier.