Exploring Disease Manifestations and Influencing Factors in Acute and Chronic Hepatitis B
Keywords:
Acute hepatitis B, chronic hepatitis B, disease manifestations, control strategy, logistics regression
Abstract
Scope and Aims: The investigation of disease manifestations and influencing factors in both acute hepatitis B (AHB) and chronic hepatitis B (CHB) remains limited, with varying results. This study aimed to explore the factors influencing AHB and CHB and their disease manifestations within a Ghanaian population, with the goal of developing a control strategy.
Methods: A retrospective study was conducted on 569 admitted hepatitis B cases. Demographic data and disease manifestations were compared between AHB and CHB patients. Logistic regression and correlation analyses were employed to identify the factors influencing the progression of the disease.
Results: Significant differences were observed between AHB and CHB patients in terms of median age and hospitalization duration. Variations in age, gender, education level, and occupational distributions were statistically significant (P < 0.05) between the two groups. Symptoms such as fever, nausea, polydipsia, palpitation, anicteric presentation, anorexia, and itching were less common in CHB patients (P < 0.05), while abdominal pain, jaundice, and enlarged liver were more frequent (P < 0.05). CHB patients exhibited significantly higher levels of aspartate aminotransferase, viral load, bilirubin, prothrombin time, partial thromboplastin time, HBeAg, albumin, abdominal ultrasound findings, and globin (P < 0.05), while HBsAg and liver function test levels were significantly lower (P < 0.05) in CHB patients compared to AHB patients. Logistic regression identified age, gender, occupation, education level, and hospitalization duration as significant influencing factors.
Conclusion: Males and the adult population represented a higher proportion of CHB patients, with a significant association between CHB and elevated clinical and laboratory characteristics. Age, gender, occupation, education level, and hospitalization duration were established as key influencing factors in the progression of hepatitis B.
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References
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17. Hugo LG, Lourdes GG, Gabriela EA, Pablo CH, María OP, Deyanira CD, et al. (2018). Hepatitis B seroprevalence in 10-25-year-olds in Mexico - the 2012 national health and nutrition survey (ENSANUT) results, Human Vaccines & Immunotherapeutics, DOI: 10.1080/21645515.2018.1533617.
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24. Lavanchy D. (2004) Hepatitis B virus epidemiology, disease burden, treatment, and current and emerging prevention and control measures. J Viral Hepat. 11(2):97-107.
25. Li MR, Zheng HW, Ma SM, Liu YY, Qie LX, Li JQ, et al. (2018) Correlations between serum hepatitis B surface antigen and hepatitis B core antibody titers and liver fibrosis in treatment-naïve CHB patients. J Chin Med Assoc. 81(12):1052-1059.
26. Martinson FE, Weigle KA, Mushahwar IK, Weber DJ, Royce R, Lemon SM. (1996). Seroepidemiological survey of hepatitis B and C virus infections in Ghanaian children. Journal of medical virology, 48(3): 278-83.
27. McMahon BJ, Alward WL, Hall DB, Heyward WL, Bender TR, Francis DP. et al. (1985). Acute hepatitis B virus infection: relation of age to the clinical expression of disease and subsequent development of the carrier state. J Infect Dis. 151:599-603.
28. Mkandawire P, Richmond C, Dixon J, Luginaah IN, Tobias J. (2013). Hepatitis B in Ghana’s Upper West Region: a hidden epidemic in need of national policy attention. Health Place. 23:89–96. DOI: 10.1016/j.healthplace.2013.06.001.
29. National Institute for Public Health and the Environment (RIVM). Hepatitis B. http://www.rivm.nl/Onderwerpen/H/Hepatitis B. [Accessed 21 November 2023].
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31. Nazarnezhad M, Moosavy SH, Davoodian P, Eftekhar E, Nejatizadeh A, Azad M. (2018). The demographic and paraclinical characteristics of patients with hepatitis B presenting to Shahid Mohammadi Hospital and Clinic and other private clinics in Bandar Abbas, Iran. J Adv Pharm Technol Res. 9:139-46.
32. Ochola E, Ocama P, Orach CG, Nankinga ZK, Kalyango JN, McFarland W, et al. (2013). High burden of hepatitis B infection in Northern Uganda: results of a population-based survey. BMC Public Health, 13:727.
33. Owusu-Ansah T. (2014). Viral Hepatitis in Ghana: The Role of the Government http://www.ghanaweb.com/GhanaHomePage/NewsArchive/Viral-Hepatitis-In-Ghana-The-Role-Of-The-Government-222118 [Accessed 15 September 2023].
34. Ozer A, Yakupogullari Y, Beytur A, Beytur L, Koroglu M, Salman F, et al. (2011). Risk factors of hepatitis B virus infection in Turkey: a population-based, case-control study: risk factors for HBV infection. Hepat Mon. (4);11:263–8.
35. Ratnam D, Visvanathan K. (2008). New concepts in the immunopathogenesis of chronic hepatitis B: the importance of the innate immune response. Hepatol Int. 2(1):12–18.
36. Rehermann B, Nascimbeni M. (2005). Immunology of hepatitis B virus and hepatitis C virus infection. Nat Rev Immunol. 5:215–29.
37. Sali S, Alavian SM, Foster GR, Keyvani, H, Mehrnoosh L, Mohammadi N. (2013). Influencing Factors on the Outcome and Prognosis of Patients With HBV Infection: Seven Years Follow-up. Hepatitis Monthly, 13:e8743. http://doi.org/10.5812/hepatmon.8743.
38. Salimi N, Jahan A, Hazrati S. (2014). Evaluation of the prevalence of hepatitis B surface antigen and its related factors in pregnant women referring to health centres in Ardabil city in 2009. Health J. 5:58-248.
39. Teye J. (2015). Ghana risks losing productive youth to Hepatitis-Medical Professor. http://www.myjoyonline.com/lifestyle/2015/September-15th/ghana-risks-losing-productive-youth-to-hepatitis-medical-professor.php. [Accessed 15 September 2019].
40. van Ballegooijen WM, van Houdt R, Bruisten SM, Boot HJ, Coutinho RA, Wallinga J. (2009). Molecular sequence data of hepatitis b virus and genetic diversity after vaccination. American Journal of Epidemiology, 170(12):1455–1463.
41. van de Laar MJW, Beuker RJ, Rijlaarsdam J, van Duynhoven YTHP. (2000). Hepatitis B. Technical Report 441500 011, National Institute for Public Health and the Environment (RIVM).
42. van Houdt R, Bruisten SM, Speksnijder AG, Prins M. (2012). Unexpectedly high proportion of drug users and men having sex with men who develop chronic hepatitis B infection. Journal of Hepatology, 57(3):529–533.
43. Walana W, Hokey P, Ahiaba S. (2014). Sero-Prevalence of Hepatitis B Virus Infection among Blood Donors: A Retrospective Study in the Kintampo Municipal Hospital, Ghana. Open Journal of Medical Microbiology, 4: 64-9.
44. World Health Organization. (2002). Global alert and response (gar): Hepatitis B, http://www.who.int/csr/disease/hepatitis/whocdscsrlyo20022/en/index3.html [Accessed 21 November 2023].
45. World Health Organization. (2013). Fact sheet no 204: Hepatitis B. http://www.who.int/mediacentre/factsheets/fs204/en/ [Accessed 21 November 2019].
46. Yang S, Ding C, Cui Y, Wu J, Yu C, Chen P, et al. (2017). Prevalence and influencing factors of hepatitis B among a rural residential population in Zhejiang Province, China: a cross-sectional study. BMJ Open, 7(4):e014947. DOI:10.1136/bmjopen-2016- 014947
2. Acquaye JK, Mingle JA. (1994). Hepatitis B viral markers in Ghanaian pregnant women. West African journal of medicine. 13(3): 134-7.
3. Alavian SM, Tabatabaei SV, Ghadimi T, Beedrapour F, Kafi-Abad SA, Gharehbaghian A, et al. (2012). Seroprevalence of hepatitis B virus infection and its risk factors in the west of Iran: a population-based study. Int J Prev Med. 3:770–5.
4. Asadi Noghabi AA, Zandi M, Mehran A, Alavian SM, Dehkordi AH. (2010). The Effect of Education on Quality of Life in Patients under Interferon Therapy. Hepatitis Monthly, 10:218-22.
5. Averhoff F. (2016). Hepatitis B. http://wwwnc.cdc.gov/travel/yellowbook/2016/infectious-diseases-related-to-travel/hepatitis-B. [Accessed 23 September 2023].
6. Behal R, Jain R, Behal KK, Bhagoliwal A, Aggarwal N, Dhole TN. (2008). Seroprevalence and risk factors for hepatitis B virus infection among the general population in Northern India. Arq Gastroenterol, 45 (2):137–40.
7. Centers for Disease Control and Prevention (2005). Guidelines For Viral Hepatitis Surveillance And Case Management. Atlanta, GA: Centers for Disease Control and Prevention. http://www.cdc.gov/hepatitis/PDFs/ 2005Guidlines-Surv-CaseMngmt.pdf. [Accessed 23 September 2023].
8. Deng QJ, Pan YQ, Wang CY, Li FL, Lv SJ, Hu SY, Ning T, et al. (2013). Prevalence and risk factors for hepatitis B in Hua County, Henan Province. Beijing Da Xue Xue Bao 2013;45 (6):965–70.
9. Deny P, Zoulim F. (2010). Hepatitis B virus: from diagnosis to treatment. Pathol Biol (Paris) 58:245–53.
10. Dongdem JT, Kampo S, Soyiri IN, Asebga PN, Ziem JB, Sagoe K. (2012). Prevalence of hepatitis B virus infection among blood donors at the Tamale Teaching Hospital, Ghana (2009). BMC research notes, 5: 115.
11. Ganem D, Prince AM. (2004). Hepatitis B virus infection-natural history and clinical consequences. N Engl J Med. 350:1118–29.
12. GhanaWeb. (2013). Ghana Rated High Risk for Hepatitis B and http://www.ghanaweb.com/GhanaHomePage/health/Ghana-rated-high-risk-for-Hepatitis B-C-280781. [Accessed 16 September 2023].
13. Gheorghe L, Csiki IE, Iacob S, Gheorghe C. (2013). The prevalence and risk factors of hepatitis B virus infection in an adult population in Romania: a nationwide survey. Eur J Gastroenterol Hepatol. 25(1):56–64.
14. Han YT, Sun C, Liu CX, Xie SS, Xiao D, Liu L, et al. (2014). Clinical features and outcome of acute hepatitis B in pregnancy. BMC Infect Dis. 14:368.
15. He YL, Zhao YR, Zhang SL, Lim SM. (2006) Host susceptibility to persistent hepatitis B virus infection. World J Gastroenterol, 12(30):4788–93.
16. Howell J, Ladep NG, Lemoine M, Thursz MR, Taylor-Robinson SD. (2014). Hepatitis B in Sub-Saharan Africa. South Sudan Med J. 7(3):59–61.
17. Hugo LG, Lourdes GG, Gabriela EA, Pablo CH, María OP, Deyanira CD, et al. (2018). Hepatitis B seroprevalence in 10-25-year-olds in Mexico - the 2012 national health and nutrition survey (ENSANUT) results, Human Vaccines & Immunotherapeutics, DOI: 10.1080/21645515.2018.1533617.
18. Hur K, Wong M, Lee J, Lee J, Juon HS. (2012). Hepatitis B infection in the Asian and Latino communities of Alameda County, California. J Community Health 37 (5):1119–26.
19. Janahi EM. (2014). Prevalence and risk factors of hepatitis B virus infection in Bahrain, 2000 through 2010. PLoS One. 9:e87599.
20. Keshvari M, Alavian SM, Sharafi H.(2015). Comparison of Serum Hepatitis B Virus DNA and HBsAg Levels Between HBeAg-Negative and HBeAg-Positive Chronic Hepatitis B Patients. Jundishapur J Microbiol. 8(3): e21444.
21. Khan F, Shams S, Qureshi ID, Israr M, Khan H, Sarwar MT, et al. (2011). Hepatitis B virus infection among different sex and age groups in Pakistani Punjab. Virol J. 8:225.
22. Khosravani A, Sarkari B, Negahban H, Sharifi A, Toori MA, Eilami O. (2012). Hepatitis B Infection among the high-risk population: a seroepidemiological survey in the southwest of Iran. BMC Infect Dis. 12:378.
23. Kumar M, Sarin SK, Hissar S, Pande C, Sakhuja P, Sharma BC, et al. (2008) Virologic and histologic features of chronic hepatitis B virus-infected asymptomatic patients with persistently normal ALT. Gastroenterology, 134(5):1376-84.
24. Lavanchy D. (2004) Hepatitis B virus epidemiology, disease burden, treatment, and current and emerging prevention and control measures. J Viral Hepat. 11(2):97-107.
25. Li MR, Zheng HW, Ma SM, Liu YY, Qie LX, Li JQ, et al. (2018) Correlations between serum hepatitis B surface antigen and hepatitis B core antibody titers and liver fibrosis in treatment-naïve CHB patients. J Chin Med Assoc. 81(12):1052-1059.
26. Martinson FE, Weigle KA, Mushahwar IK, Weber DJ, Royce R, Lemon SM. (1996). Seroepidemiological survey of hepatitis B and C virus infections in Ghanaian children. Journal of medical virology, 48(3): 278-83.
27. McMahon BJ, Alward WL, Hall DB, Heyward WL, Bender TR, Francis DP. et al. (1985). Acute hepatitis B virus infection: relation of age to the clinical expression of disease and subsequent development of the carrier state. J Infect Dis. 151:599-603.
28. Mkandawire P, Richmond C, Dixon J, Luginaah IN, Tobias J. (2013). Hepatitis B in Ghana’s Upper West Region: a hidden epidemic in need of national policy attention. Health Place. 23:89–96. DOI: 10.1016/j.healthplace.2013.06.001.
29. National Institute for Public Health and the Environment (RIVM). Hepatitis B. http://www.rivm.nl/Onderwerpen/H/Hepatitis B. [Accessed 21 November 2023].
30. National Institute for Public Health and the Environment (RIVM). Nationaal Kompas volksgezondheid: Hepatitis B, 2013. http://www.nationaalkompas.nl/gezondheid-en-ziekte/ ziekten-en-aandoeningen/infectieziekten-en-parasitaire-ziekten/soa/hepatitis-B. [Accessed 21 November 2023].
31. Nazarnezhad M, Moosavy SH, Davoodian P, Eftekhar E, Nejatizadeh A, Azad M. (2018). The demographic and paraclinical characteristics of patients with hepatitis B presenting to Shahid Mohammadi Hospital and Clinic and other private clinics in Bandar Abbas, Iran. J Adv Pharm Technol Res. 9:139-46.
32. Ochola E, Ocama P, Orach CG, Nankinga ZK, Kalyango JN, McFarland W, et al. (2013). High burden of hepatitis B infection in Northern Uganda: results of a population-based survey. BMC Public Health, 13:727.
33. Owusu-Ansah T. (2014). Viral Hepatitis in Ghana: The Role of the Government http://www.ghanaweb.com/GhanaHomePage/NewsArchive/Viral-Hepatitis-In-Ghana-The-Role-Of-The-Government-222118 [Accessed 15 September 2023].
34. Ozer A, Yakupogullari Y, Beytur A, Beytur L, Koroglu M, Salman F, et al. (2011). Risk factors of hepatitis B virus infection in Turkey: a population-based, case-control study: risk factors for HBV infection. Hepat Mon. (4);11:263–8.
35. Ratnam D, Visvanathan K. (2008). New concepts in the immunopathogenesis of chronic hepatitis B: the importance of the innate immune response. Hepatol Int. 2(1):12–18.
36. Rehermann B, Nascimbeni M. (2005). Immunology of hepatitis B virus and hepatitis C virus infection. Nat Rev Immunol. 5:215–29.
37. Sali S, Alavian SM, Foster GR, Keyvani, H, Mehrnoosh L, Mohammadi N. (2013). Influencing Factors on the Outcome and Prognosis of Patients With HBV Infection: Seven Years Follow-up. Hepatitis Monthly, 13:e8743. http://doi.org/10.5812/hepatmon.8743.
38. Salimi N, Jahan A, Hazrati S. (2014). Evaluation of the prevalence of hepatitis B surface antigen and its related factors in pregnant women referring to health centres in Ardabil city in 2009. Health J. 5:58-248.
39. Teye J. (2015). Ghana risks losing productive youth to Hepatitis-Medical Professor. http://www.myjoyonline.com/lifestyle/2015/September-15th/ghana-risks-losing-productive-youth-to-hepatitis-medical-professor.php. [Accessed 15 September 2019].
40. van Ballegooijen WM, van Houdt R, Bruisten SM, Boot HJ, Coutinho RA, Wallinga J. (2009). Molecular sequence data of hepatitis b virus and genetic diversity after vaccination. American Journal of Epidemiology, 170(12):1455–1463.
41. van de Laar MJW, Beuker RJ, Rijlaarsdam J, van Duynhoven YTHP. (2000). Hepatitis B. Technical Report 441500 011, National Institute for Public Health and the Environment (RIVM).
42. van Houdt R, Bruisten SM, Speksnijder AG, Prins M. (2012). Unexpectedly high proportion of drug users and men having sex with men who develop chronic hepatitis B infection. Journal of Hepatology, 57(3):529–533.
43. Walana W, Hokey P, Ahiaba S. (2014). Sero-Prevalence of Hepatitis B Virus Infection among Blood Donors: A Retrospective Study in the Kintampo Municipal Hospital, Ghana. Open Journal of Medical Microbiology, 4: 64-9.
44. World Health Organization. (2002). Global alert and response (gar): Hepatitis B, http://www.who.int/csr/disease/hepatitis/whocdscsrlyo20022/en/index3.html [Accessed 21 November 2023].
45. World Health Organization. (2013). Fact sheet no 204: Hepatitis B. http://www.who.int/mediacentre/factsheets/fs204/en/ [Accessed 21 November 2019].
46. Yang S, Ding C, Cui Y, Wu J, Yu C, Chen P, et al. (2017). Prevalence and influencing factors of hepatitis B among a rural residential population in Zhejiang Province, China: a cross-sectional study. BMJ Open, 7(4):e014947. DOI:10.1136/bmjopen-2016- 014947
Published
2024-11-30
How to Cite
Sam, N. B., Ofosu, A. S., & Majeed, S. F. (2024). Exploring Disease Manifestations and Influencing Factors in Acute and Chronic Hepatitis B. European Scientific Journal, ESJ, 20(33), 59. https://doi.org/10.19044/esj.2024.v20n33p59
Section
ESJ Natural/Life/Medical Sciences
Copyright (c) 2024 Napoleon Bellua Sam, Abena Serwaa Ofosu, Saeed Folorunsho Majeed
This work is licensed under a Creative Commons Attribution 4.0 International License.
