Occult Hepatitis B and Advanced Chronic Liver Disease at the University Hospital of Libreville (Gabon)
Abstract:
Introduction: Occult hepatitis B is a common but poorly described condition in Gabon. The objective of this study was to identify occult hepatitis B as a probable cause of cirrhosis of unknown etiology.
Materials and Methods: This was a prospective, descriptive, and analytical cross-sectional study conducted in the Hepatogastroenterology Department of the Libreville University Hospital between January 1 and Decem ber 31, 2022. We included all volunteer patients being treated for cirrhosis. We excluded patients with cirrhosis of viral hepatitis B, viral hepatitis C, or alcoholic etiology. Patients with cirrhosis of unknown etiology under went real-time PCR for hepatitis B genome detection and concurrent measurement of HBc and HBs antibodies. Sociodemographic data, medical history and risk factors, as well as diagnostic data, were collected. Data analysis was performed using R software version 4.1.1.
Results: We had 33 patients with cirrhosis of unknown etiology, 13 of whom had occult hepatitis B with a low detectable HBV viral load in serum (39.39%). HBc antibodies were present in 100% of these patients, and HBs antibodies in 30.77%. The male-to-female ratio was 1.6, with a mean age of 43.8 ± 9.3 years. The cirrhosis was classified as Child- Pugh C in 76.92% of cases, and hepatocellular carcinoma was present in 23.08%. Factors associated with HBO (Table II) were the notion of vaccination against HBV (OR 2.12 [1.8-3.18], p 0.015), the notion of a parent with hepatitis B (OR 1.8 [1.56-2.14] p 0.041); the notion of blood transfusion (OR 2.05 [1.07-3.62] p 0.024) and ritual scarifications (OR 1.91 [1.66-2.98].
Conclusion: Occult hepatitis B is a common cause of presumed cryptogenic cirrhosis.
