Seroepidemiology of Hepatitis B Virus in the Population of the Northern Part of Palestine

Seroepidemiology of Hepatitis B Virus in the Population of the Northern Part of Palestine

Ammar Wasef S. Al-Refa'i A total of 3030 blood samples were collected from Palestinian subjects and tested for hepatitis B surface antigen (HbsAg). These include: blood donors (1659), pregnant women (564), staff and students (309) and family members of HbsAg positive subjects (498). The prevalence rates of HbsAg were 3.4% in healthy blood donors, 3.9% in pregnant women and 4.9% in staff and students. The incidence rate of 10.6% was found among family members of HbsAg positive carriers. These results indicate that Palestine is situated in an area with intermediate endemicity for HBV infection. The observed differences in the prevalence of HbsAg positive carriers in terms of age and sex did not reach the level of statistical significance. Statistically significant difference were observed in the prevalence rates of HbsAg positive carriers in terms of history of contact with a jaundiced person, history of blood transfusion, haemodialysis, hygiene, socioeconomic status, place of residence and family size. A significant difference in the prevalence of HbsAg carrier status between children of HbsAg positive mothers and those of HbsAg negative mothers was observed and infection appears to be acquired mostly in the postnatal period. The spread between siblings implying other possible modes of transmission of HBV beside sex and blood transfusion. The seroprevalence of HBV markers (HbeAg, anti-Hbe, anti-HBc, anti-HBs) were investigated in all HbsAg positive subjects (147), and the subject were grouped into three patterns based on their serological markers. The prevalence rates for HbeAg positive pattern was 19.7% for anti-Hbe positive pattern was 44.2% and for HbeAg/anti-Hbe negative pattern was 36.1%. Elevated ALT levels were found mainly in association with more than 50% HbeAg positive subjects. Seroconversion of HBV markers was investigated after 12 months from the first testing date. Based on the detection of anti-HBs, complete recovery was observed in 8.8% of HbsAg positive subjects.  Seroconversion rate from HBsAg to anti-HBs, on follow up, was dependent on the presence or absence of HbeAg. The persistance of HbsAg was found much lower in HbeAg negative subjects. Of 339 HbsAg alone was detected in 1.2% of these subjects. This finding strongly indicates that testing for HbsAg alone may fail to detect all HBV infections. Ammar Wasef S. Al-Refa'i Supervisors Dr. Yahya R. Fadi  Dr. Nael S. Abu-Hasan 1996 Zajel / An-Najah National University