Liver Histopathological Features of HBeAg-Negative Chronic Hepatitis B in Young Bangladeshis.

Background and Aims: Hepatitis B virus (HBV) infection is common in Bangladesh. However, the characteristics of young patients incidentally detected with hepatitis B e antigen (HBeAg)-negative chronic hepatitis B is yet to be studied in this country. Methods: We did percutaneous liver biopsies in 36 patients with chronic hepatitis B (CHB) aged between 8 and 20 years. They were all HBeA9-negative with persistently normal or raised serum alanine aminotransferase (ALT) values. Results: 56% of patients had significant necro-inflammation. Significant fibrosis was seen in 17.6% of patients. Serum ALT was raised in 38.2%. A high HBV DNA load was observed only in 26.5% of patients. HBeAg-negative CHB is assumed not to be present in the age group studied, since this is the age group that represents immunotolerance to CHB. Immunotolerant CHB patients are positive for HBeAg, have normal ALT with high HBV DNA load. However, our study not only documented that HBeAg-negative CHB is common in our young population, but the data were also in contrary to what was expected in such age group of CHB patients. Conclusions: HBeA9-negative CHB is an entity that can be seen in young population and a significant percentage of such patients may have considerable hepatic involvement. [ABSTRACT FROM AUTHOR]