HBsAg carriers among healthy Nepalese men: a serological survey

The prevalence of hepatitis B surface antigen (HBsAg) was studied among 2,585 healthy Nepalese men, aged 16-50 years, who required medical check-ups for employment abroad. Serum samples, collected during July-September 1999, were tested for HBsAg using a third-generation ELISA kit. Of the 2,585 men, 24 (0.93%) were positive for HBsAg, indicating that hepatitis B infection in the target group was below the intermediate endemicity. The prevalence of HBsAg was minimum (0.36%) in the central development region, followed by western, eastern and mid-western development regions (0.82%,1.16%, and 2.08% respectively, chi2 = 4.76, p < 0.2). The positivity of HBsAg was slightly higher in the hilly region (1.11%) than in the terai (0.84%) and mountainous regions (0%), which was not significant (chi2 = 2.1, p < 0.5). The prevalence was highest in the 46-50-year age group. Alanine aminotransferase was tested in all 24 positive and 150 negative subjects to indicate the stage of infection. Seven (29.16%) of the 24 positive cases had elevated alanine aminotransferase, indicating associated liver damage (chi2 = 4.16, p < 0.05) and it was significantly associated with positivity of HBsAg (chi2 = 32.6, p < 0.001). All 9 positive subjects from the terai region had normal alanine aminotransferase, whereas 7 of the 15 subjects from the hilly region had it elevated (chi2 = 1.76, p < 0.001). Seven (29%) of the positive subjects were chronic carriers with its sequel in the liver, and the remaining 17 subjects (70.84%) may be in the incubation period or convalescent stage or may be chronic carriers. The results suggest that the population should be educated about the sequel of the infection.