HEPATITIS B SURFACE ANTIGEN

SCREENING IN YOUNG PAKISTANI MALES

Abstract

Hepatitis B is one of the most common infectious diseases in the world
with over 350 million chronic carriers worldwide. In Pakistan, most of the studies have been done in high risk groups
such as health care workers, voluntary blood donors etc. Few studies have been reported in general population so far.
Therefore, there is dearth of knowledge regarding prevalence of HBV infection in young males seeking employment
in various sectors of society. Objective: To investigate the prevalence of hepatitis B surface antigen (HBs Ag) in a
population-based sample of healthy young males that were drawn from various regions of Pakistan for recruitment.
Place & Duration of Study: Combined Military Hospital, Attock, from Jan 2001 to Mar 2002. Design: Cross-sectional
observational Subjects and Methods: A total number of 4552 healthy young males who reported for pre-recruitment
physical examination, belonging to all the provinces of Pakistan, Northern areas and Azad Kashmir were screened for
HBs Ag by immunochromatographic technique. The positive result was confirmed using Enzyme Immunoassay kit.
Results: Out of the total of 4552 healthy young males; HBsAg was positive in 190 subjects (4.2%). Prevalence of HBs
Ag in individuals from Sindh was significantly higher than those from other regions. Major risk factors for HBV infection
were sharing of razors (56.8%), history of intravenous injections (39.5%), jaundice in the subject (18.4%) and jaundice
in family (18.9%). In HBs Ag positive subjects, 11.1% revealed no identifiable risk factor. Conclusion: There is more
than two fold reduction in the HBs Ag prevalence over the last ten years. Major risk factors in the population are
exposure to contaminated blood and use of needle sticks. However, a sizeable number of HBV infection do occur in
our young healthy males which go undetected and are only detected on screening at the time of employment. Despite
the already detailed knowledge about the transmission of hepatitis B, more work is required to search other mode of
transmission on Hepatitis B.