Diagnostic incidence of the presence of positive HBsAg: epidemiologic, clinical, and virological characteristics
Autor: | M.ª Rosa González Palacio, Belén Costero Pastor, David del Pozo Prieto, Cecilia Sanz García, José Ignacio Busteros Buraza, Elvira Poves Martínez, Inmaculada Beceiro Pedroño, G. Rodríguez |
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Rok vydání: | 2012 |
Předmět: |
Adult
Male medicine.medical_specialty HBsAg Hepatitis B virus Genotype Epidemiology Biopsy Population Emigrants and Immigrants Gastroenterology Antiviral Agents Young Adult Diagnostic incidence Internal medicine Drug Resistance Viral medicine Adefovir HBV Humans Aspartate Aminotransferases Prospective Studies education Aged education.field_of_study Hepatitis B Surface Antigens medicine.diagnostic_test business.industry Alanine Transaminase General Medicine Entecavir Jaundice Middle Aged Viral Load Hepatitis B Hepatitis D HBeAg Liver Spain Liver biopsy Immunology DNA Viral Female medicine.symptom Hepatitis Delta Virus business Viral load medicine.drug |
Zdroj: | Revista Española de Enfermedades Digestivas v.104 n.1 2012 SciELO España. Revistas Científicas Españolas de Ciencias de la Salud instname |
ISSN: | 1130-0108 |
Popis: | Objective: to analyze the epidemiological, clinical, and virological characteristics of patients newly diagnosed with active hepatitis B virus (HBV) infection based on the presence of positive hepatitis B surface antigen (HBsAg) in the digestive diseases department of a district hospital. Patients and methods: we performed a 3-year prospective study in patients newly diagnosed with HBV infection. We analyzed epidemiological, clinical, and virological characteristics, complete HBV markers, quantification of HBV DNA, and infection by hepatitis delta virus. We performed genotyping and resistance testing in patients with a high viral load. Results were obtained for patients who required liver biopsy. Results: we diagnosed 213 patients (18.8/10,000 inhabitants/year). Men accounted for 61%, and 59% were aged 20 to 40 years. Immigrants accounted for 53% of the population: 46% were from Rumania and 37% from Sub-Saharan African countries. At diagnosis, 2.3% had acute hepatitis (all with jaundice) and 3.3% had cirrhosis with portal hypertension. With the exception of cases of acute hepatitis, positive HBeAg was observed in 9%. Serum transaminase levels were normal in 62.2% of patients, HBV DNA was > 2,000 IU/mL in 33.8%, and delta virus was present in 3.3%. Genotyping and resistance testing were performed in 70 patients: the most common genotype was D, followed by A. Resistance was detected at baseline in only 2 cases: to adefovir in one case and to entecavir in another. Among the 36 biopsies performed, 32.4% showed inflammatory activity ≥ 2, and 23.5% had fibrosis ≥ 2 according to the METAVIR scoring system. According to clinical practice, specific treatment for HBV infection was necessary (any reason) in 17.4% of those diagnosed (3 patients per 100,000 inhabitants/year). Conclusions: despite prevention and vaccination, HBV infection is a health problem that most commonly affects the immigrant population and men. Serum transaminase levels are normal in 62.2% of patients. The most frequent genotype is D, followed by A, and baseline resistance is scarce. |
Databáze: | OpenAIRE |
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