Choudhuri Gourdas, Gupta Varun, Negi Tajinder Singh, Ojha Rajesh
HOPE (Health Oriented Programs and Education) Initiative, 422, Aradhana, Eldeco 2, Rae Bareli Road, Lucknow 226025, UP, India.
Department of Gastroenterology and Hepatobiliary Sciences, Fortis Memorial Research Institute, Sector 44, Gurgaon 122002, Haryana, India.
J Clin Exp Hepatol. 2019 Jan-Feb;9(1):43-49. doi: 10.1016/j.jceh.2018.02.005. Epub 2018 Feb 16.
In a developing country like India with intermediate level of prevalence of hepatitis B, most of the patients remain undiagnosed as they are asymptomatic. The purpose of the study was to diagnose asymptomatic HBsAg positive patients from the general population and evaluate further the potential clinical implications of IDAHS.
Asymptomatic subjects with unknown HBV status were screened free of cost for hepatitis-B surface antigen. Those who tested positive for HBsAg were further tested to identify those who were potential candidates for anti-viral therapy. To explore the relevance of our screening we assessed potential implications of HBsAg detection.
A total of 30,836 patients were screened in medical camps over the period of 7 years. Out of these 704 (2.3%) subjects were found to be positive for HBsAg. Distress of being diagnosed with HBV was expressed by 649 (92%) of the positive subjects. High cost of further testing and antiviral therapy, leading to inability to pursue further management was elicited in 510 (72%) of the positive subjects. HBV DNA was detected in 349 (59%) out of 592 subjects, out of which 236 (67%) had high viral load.
Incidental detection of asymptomatic HBsAg positive subjects was seen in 2.3% of subjects. One third of these patients had an actively replicating virus and required antiviral therapy. Financial support was required in 72% of the subjects for further HBV management. Detecting HBsAg in asymptomatic person in an endemic community has considerable health and psycho-economic impact on the individual.
在像印度这样乙型肝炎患病率处于中等水平的发展中国家，大多数患者因无症状而未被诊断出来。本研究的目的是从普通人群中诊断出无症状的乙肝表面抗原（HBsAg）阳性患者，并进一步评估隐匿性乙肝表面抗原血症（IDAHs）的潜在临床意义。
对乙肝病毒（HBV）状态未知的无症状受试者免费进行乙肝表面抗原筛查。对HBsAg检测呈阳性的受试者进一步检测，以确定那些可能适合抗病毒治疗的人。为了探究我们筛查的相关性，我们评估了HBsAg检测的潜在影响。
在7年期间，共有30836名患者在医疗营地接受了筛查。其中704名（2.3%）受试者的HBsAg检测呈阳性。649名（92%）阳性受试者表达了被诊断为乙肝病毒感染的苦恼。510名（72%）阳性受试者表示，进一步检测和抗病毒治疗费用高昂，导致无法继续接受进一步治疗。在592名受试者中，349名（59%）检测出乙肝病毒脱氧核糖核酸（HBV DNA），其中236名（67%）病毒载量高。
2.3%的受试者偶然检测出无症状HBsAg阳性。这些患者中有三分之一的病毒处于活跃复制状态，需要进行抗病毒治疗。72%的受试者需要经济支持以进行进一步的乙肝病毒治疗。在地方性社区中对无症状个体检测HBsAg对个人有相当大的健康和心理经济影响。
