Spectrum of hepatitis B virus infection in Ethiopia

A total of 304 Ethiopian patients with acute or chronic hepatitis B have been found to be positive for hepatitis B surface antigen (HBsAg) at the Virology Section of the Central Laboratory and Research Institute in Addis Ababa over the period 1981-1984. On the basis of the spectrum of hepatitis B virus (HBV) infection, the 304 patients could be divided into 5 groups. The first group includes the vast majority of the patients, i.e., up to 85% (260/304) and is characterized by rapid clearance of HBsAg and by rapid recovery from infection. In this group of patients, hepatitis B was a self-limiting infection. The second group comprises the 10% (30/304) of patients identified as asymptomatic chronic carriers of HBsAg; liver function tests on these patients were usually normal after two and a half months from the onset of infection, but HBsAg persisted in the patients for more than 6 months. The third group, which accounts for 5% (14/304) of patients includes those chronically infected by HBV and suffering from some form of malignant liver disease, mainly hepatocellular carcinoma (HCC). The specific markers detected in those patients with HCC were HBsAg and alpha-fetoprotein. Most of the patients in this group were comparatively old (55 years and above). The fourth group consists of a subgroup of patients of the first group with self-limiting hepatitis B, who were simultaneously infected by the delta agent, as shown by the detection of anti-delta antibody in 2.7% (3/111) of the patients. The fifth group is constituted by the young males between the ages of 21 and 30 years, accounting for 40% (122/304) of patients.(ABSTRACT TRUNCATED AT 250 WORDS)