Seroepidemiology of Incidentally Detected Asymptomatic HBsAg Positive Subjects from Southern State of India – A One Year Study

Introduction: Hepatitis B virus infection is assuming a silent epidemic phase in India. Majority of the chronically infected are asymptomatic and unaware of their status. This pool of individuals called; incidentally detected hepatitis B positive subjects [IDAHS], unknowingly transmits infection to their contacts for decades. In order to curb the spread of infection they need to be identified tested, followed up and treated if required.

Aim: To assess the prevalence of asymptomatic Hepatitis B virus infection and risk factors for acquisition of same. Serological and biochemical profile of these individuals and influence of demographic factors on these markers.

Study Design: A cross sectional and observational study.

Place and Duration of Study: January 2014- January 2015 at Princes Esra Hospital of Deccan College of Medical Sciences.

Methodology: A total of 3260 blood samples were screened for hepatitis B surface antigen. Serum from IDAHS was later subjected to various serological and biochemical tests.

Results: Hepatitis B surface antigen was detected in 3.8% of the screened individuals. All were asymptomatic for the hepatitis B virus infection. Of the various risk factors enquired, intake of frequent intramuscular injections was the most common noted. Male predominance was seen for HBsAg and HBeAg as 56% and 100%. HBeAg and antiHBe were positive in 8% and 80% of individuals tested. Majority of the HBsAg and HBeAg positive subjects as 65% and 56% were young less than 30 years of age indicating the early age of acquisition of HBV infection and development of carrier state by 3rd decade of life. AntiHBc IgM and antiHBc IgG were positive in 20% and 98% of the individuals respectively. AntiHBs was above 10 IU/L in 4% of the tested. Serum alanine transaminase was raised in 12% of the individuals and all were HBeAg negative and antiHBe positive.

Conclusion: In light of above findings we suggest that a strategy is to be developed and implemented by public health care authorities to identify, evaluate, follow-up, link and treat these cases to contain the spread of infection.