Detection of Hepatitis B DNA Positive among the Hepatitis B Surface Antigen in a Postitive Sample in Tertiary Care Hospital of Mid-Western Nepal

Abstract

Introduction: Hepatitis B virus infection poses a serious risk to public health around the globe, especially in developing countries, and is leading cause of chronic hepatitis, liver cirrhosis, and hepatocellular carcinoma. Hepatitis B virus DNA is used now more often to detect Hepatitis B virus infection in cases when serologic markers are insufficient, to detect viral replication and infectivity, and to assess prognosis and treatment. The study aimed to determine detection of hepatitis B DNA (HBV DNA) among Hepatitis B surface antigen (HbsAg) among positive samples in a tertiary care hospital of western Nepal.

Methods: A descriptive cross-sectional study was conducted at Department of Microbiology, Nepalgunj Medical College Teaching Hospital from January 2021 to July 2024 after receiving ethical approval from hospital Institutional Review Board. The serum samples of all patients were screened for HBsAg using Immuno-Chromatography Technique, and HBV DNA was further detected from HBsAg-positive sera by Real-time PCR test using Alto Star 1.5 HBV PCR Kit. This study included 53432 patients (inpatients and outpatients) attending hospital from January 2021 to July 2024. Point estimate at 99% Confidence Interval was calculated.

Results: Of 53,432 patients, 358 (0.67%) (0.58%–0.76% at 99% Confidence Interval) were confirmed as HBsAg positive. The mean age of patients who tested HBsAg-positive was 29.89 ± 17.06 years. The highest number of HBsAg-positive samples came from age 21-30, with 110 (30.72%) samples. Out of 358 HBsAg-positive samples, 272 (75.97%) yielded HBV DNA test positive.

Conclusions: The HBsAg positive samples is higher compare to study done in similar setting. High rate of HBsAg-positive/HBV DNA-negative results indicates that rapid diagnostic tests can yield a substantial number of results not indicative of active replication.