S2937 Prevalence of Acute and Chronic Liver Diseases Among Newly Detected HBsAg Positive Subjects: Experience From a Resource-Constrained Setting

Introduction: Hepatitis B surface antigen (HBsAg)-positive individuals are frequently identified during routine health check-ups, blood donations, and evaluations for liver-related illnesses. Many of them have serious liver diseases that go undetected. We conducted a prospective study to evaluate the modes of detection of hepatitis B virus (HBV) infection, awareness about HBV, and the spectrum of liver diseases in newly detected HBsAg-positive individuals. Methods: This study was conducted on consecutive patients with newly detected HBV infection who attended the outpatient department or were hospitalized at MKCG Medical College, Berhampur, India, between July 2020 and December 2024. Serological, biochemical, radiological, and endoscopic evaluations were performed. The different phases of HBV infection were identified, and treatment was provided according to INASL recommendations. Results: A total of 1,001 HBV-positive subjects were enrolled, of whom 756 (75.5%) were man. Among these individuals, 63.5% (n = 636) were detected during routine health evaluations, antenatal check-ups, or assessments for other health-related conditions; 25.2% (n = 252) during the evaluation of liver-related illnesses such as jaundice, cirrhosis, or hepatocellular carcinoma (HCC); 5.7% (n = 57) during family screening; and 5.6% (n = 56) during blood or plasma donation. Overall, 24.5% (n = 293) had evidence of liver disease, including acute viral hepatitis (7.3%, n = 73), chronic liver disease (CLD) (19.7%, n = 197), and HCC (2.3%, n = 23). Patients presenting with acute hepatitis were younger than those with CLD and/or HCC (38.93 ± 15.74 vs 47.36 ± 13.07 years; P < 0.001). Only 7.6% (n = 76) of HBV-positive individuals were aware of the consequences of hepatitis B infection, and 2.9% (n = 29) had a history of discontinuing antiviral treatment. Upon complete evaluation, 33.2% (n = 332) of patients were found to require antiviral therapy, as per INASL recommendations. Conclusion: About one-third of individuals with HBV infection had liver-related disorders, and one-tenth of these patients had HCC at the time of evaluation. Patients with liver-related illness were generally older, with most presenting in their fifth decade of life. Antiviral treatment was required in more than one-third of the patients. However, awareness of HBV-related illness was very low among HBV-positive individuals.