Comparative Study of the Degree of Severity of Hepatitis B in Preicteric, Icteric and Posticteric Hbsag Seropositive Patients Using ALT, AST, Cu, Fe, Mn, Se, Mg, Zn and Albumin

  •  Mathew OLANIYAN    
  •  J.K. Oloke    


Jaundice is the yellowish pigmentation of sclera of eye, skin and body fluids. It is associated with hepatitis B
virus infection due to the destruction of the infected hepatocytes and intrahepatic-cholestasis caused by the scars
of the healed hepatocytes. Hepatitis B patients that have never had jaundice are referred to as preicteric patients,
while those that have recovered from jaundice are referred to as posticteric hepatitis patients. Those ones
suffering from jaundice are referred to as icteric patients. This research work was designed to determine and
compare the severity of hepatitis B using the serum levels of liver enzyme, albumin and micronutrients in
HBsAg seropositive patients. One hundred and fifty HBsAg seropositive critically ill rural patients of the
Atisbo/Saki-East/Saki-West federal constituency aged 5- 79 years; (75 females: 75males) classified into
pre-icteric, icteric and posticteric patients were successfully monitored and investigated. One hundred and twelve
HBsAg seronegative and HBV non-infected apparently healthy volunteers from the same community aged 4-80
years were studied as normal control volunteers. Forty three HBsAg seropositive patients were recruited from
Ibadan as urban reference. The presence of hepatitis B surface antigen (HBsAg) and envelope antibodies to
hepatitis B, (anti-HBe) were determined in the test and control subjects serologically (ELIZA). Similarly, the
serum levels of liver enzymes Alanine-aminotransferase (ALT), and Aspartate-aminotransferase (AST) and
micronutrients (Cu, Zn, Fe, Mn, Mg and Se) were biochemically (spectrophotometry and atomic absorption
spectrophotometry) determined. Liver enzymes and albumin assays were routinely employed to recruit HBsAg
seropositive patients in active liver destruction. Antibody to envelope antigen was used to detect patients that are
infected but have been cleared of the antigens(HBsAg and HBeAg). The results obtained showed a significantly
higher mean serum values of AST,ALT,Fe,Cu and Mn with a significantly lower serum albumin, Se,Mg,and Zn
levels in patients compared with the results obtained from the controls during the 1st bleeding with P<0.05. There
were significantly higher mean serum values of AST,ALT,Fe,Cu and Mn and significantly lower serum albumin,
Se and Zn levels in patients compared with the results obtained from the control during the 2nd bleeding with
P<0.05. A significantly higher mean serum levels of ALT, AST, Cu, Fe and Mn with a lower significantly mean
serum levels of albumin, Se, and Zn was obtained in the patients than the control (P<0.05). Considering the
significant biochemical alterations(P<0.05) obtained from the HBsAg seropositive patients,hepatitis B was found
to be more severe in HBsAg seropositive icteric patients compared with posticteric and preicteric HBsAg
seropositive patients. The parameters studied could therefore be employed routinely to assess the severity of
hepatitis B.

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