Background: the profile of chronic viral hepatitis B has been little studied in Chad. The factors predictive of the presence of hepatic fibrosis are not well known. The aim of the study was to determine the biological profile of chronic HBsAg carriers according to the new European classification of chronic hepatitis B.
Method: This is a prospective cross-sectional study carried out in the gastroenterology outpatient department at the Renaissance Hospital in N’Djamena from January, 2018 to July, 2019. All patients with chronic HBsAg were included and documented for at least one year. Patients with hepatitis C, hepatitis D or HIV are known alcoholic patients and were excluded from the study. The biological profile was determined according to four forms; HBeAg positive chronic infection, HBeAg positive chronic hepatitis, HBeAg negative chronic infection, HBeAg negative chronic hepatitis and HBsAg negative phase. Factors associated with presence of significant liver fibrosis were founded by logistical regression.
Results: The average age of the patients were 42.4 years old. The sex ratio was 1.43 in favor of men and a total number of 106 patients were included. The median of the transaminase concentrations were 24 IU/ml (AST) and 21 IU/ml (ALT). 61 patients had HBeAg negative chronic infection (59.8%) and 37 patients had HBeAg negative chronic hepatitis (36.2%). HBeAg positive chronic infection and HBeA positive chronic hepatitis were both seen in 2% of the cases. Significant liver fibrosis was independently associated with the ALT levels (Odds ratio=1.038 [1.009-1.068]; p=0.009).
Conclusion: Chronic HBeAg-negative B infection is the main form found in chronic HBeAg-positive carriers. Transaminases are a predictive factor for the presence of hepatic fibrosis.