The prevalence and laboratory characteristics of chronic hepatitis B in Moscow

The chronic viral hepatitis epidemic situation is not improving in the Russian Federation. Objective. To estimate the prevalence of active forms of chronic hepatitis B (CHB) to identify those who need specific antiviral therapy. Materials and methods. In 2003 to 2010, a total of 252614 people were examined for serum HBsAg and, if the latter was found, other markers characterizing the activity of CHB. The need for therapy was determined according to the European algorithm for the management of CHB patients. Clinical, epidemiological, laboratory (blood biochemical tests, serological and molecular biological assays) and statistical studies and instrumental diagnosis (fibroelastometry) were used. Results. The prevalence of ABsAg in the Moscow Region is 4.1%. CHB is most common in the active reproductive age groups 20-29 and 30-39 years. The relative proportion of HBsAg-positive women has considerably increased in recent years. The prevalence of HBsAg-positive hepatitis is 83.5%. Hepatitis B virus (HBV) DNA was found in 63.3% of the examined HBsAg-positive persons and the viral load was high in 20.0%. Enhanced alanine aminotransferase activity was recorded in 34.9% of the patients with detectable HBV DNA; it was more significantly noted in those with a high viral load. Conclusion. The large-scale survey of the Moscow Region’s population showed a higher proportion (4.1%) of HBsAg-positive persons than annual morbidity rates and that in the study conducted in the narrow indicator groups (donors and pregnant women). According to the results of clinical and laboratory studies with consideration for HBV DNA levels, antiviral therapy for CHB is recommended for almost a quarter of patients.

HBsAg, chronic hepatitis B, HBsAg, alanine aminotransferase, hepatitis B virus DNA, fibroelastometry