Prediction of seroconversion in relation to HBsAG quantification in chronic HBV patients.

INTRODUCTION : There are approximately 400 million hepatitis B virus (HBV) carriers in the world. Till 1981, hepatitis B patients relied on serology assays (1). “E” antigen (HBeAg) was a marker of infectivity. Initially assays to quantify HBV DNA polymerase activity was done and later only HBV DNA level estimation could be done. Method used was hybridization techniques. Spontaneous e antigen seroconversion is seen in the course of chronic HBV infection. Course of B positive individuals had 2 stages as defined initially. First stage has e antigen, and HBV DNA detectable. Second stage does not have HBeAg, immeasurable DNA, and passive liver disease. Second stage patients are “healthy” carriers who are non replicative. AIM : 1. To predict the HBeAg seroconversion in relation with HBsAg quantification in patients with chronic HBV infection with antiviral treatment. 2. Clinical profile of Chronic HBV infection. 3. Clinical response of Chronic HBV infection patients with antiviral drug in a Tertiary centre. MATERIALS AND METHODS : It is a prospective study conducted between October 2010 and April 2012 where consecutive patients with the diagnosis of Chronic HBV infection undergoing medical treatment with antiviral Telbivudine from our hospital were included. During this period patients started on treatment for compensated CHB infection are included in this study. A written consent was obtained from all the patients. Institute ethical committee has approved the study. All patients with compensated CHB patients were included in the study. All patients underwent a detailed clinical evaluation at entry, with the following data: Age, gender, duration of illness, details of treatment prior to registration. Baseline demographic details such as age, gender, literacy, socio economic status, alcohol intake, smoking, religion and occupation were collected. Patient had baseline investigations such as Complete blood count, Liver function test, Prothrombin time, International normalized ratio, renal function test, HBsAg, Anti-HCV, ultra sonogram and endoscopy. CONCLUSION : In conclusion, results of our study indicate that HBsAg quantification is a good predictor of HBeAg seroconversion .Values for the HBsAg quantification from this study need to be validated by randomised prospective studies . Other parameters like age , vertical transmission and baseline ALT levels were not significant. Applying HBsAg quantification though may not be cost effective it appears to be a good predictor for e antigen seroconversion but further randomised studies are needed to evaluate the accurate prediction of e antigen seroconversion in our population