Haematological profile of acute and chronic Hepatitis B positive patients attending Komfo Anokye Teaching Hospital

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AUGUST, 2016
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Hepatitis B Virus (HBV) infection still remains a major global health problem, especially in hyper-endemic countries like Ghana. The infection presents as acute infection which may develop into chronic infection, and may be symptomatic or asymptomatic. The study determined the haematological profile likely to present at the various stages of the infection, including the acute and chronic stages seen at Komfo Anokye Hospital. The study recruited 122 each of HBV infected and uninfected subjects from 218 HBV infected and 1351 HBV uninfected patients, from August 2015 to April 2016. The infected subjects were grouped into acute and chronic subjects by their positivity or negativity respectively to HBcAb-IgM test. The infected subjects were also grouped into symptomatic and asymptomatic subjects based on their clinical signs and symptoms and their ALT levels. The Complete Blood Count, Erythrocyte Sedimentation Rate (ESR) and Peripheral Blood Examination of all the subjects were determined by standard manual and automated methods. Hepatitis B prevalence of 13.8% was recorded by the study. The HBV infected as well as the symptomatic subjects recorded significant (P<0.05) abnormally high ESR but low RBC count, Hb concentration and HCT compared to the uninfected and asymptomatic subjects who recorded normal values of these parameters. Also the symptomatic subjects recorded abnormally high Total WBC and Neutrophil count compared to the normal values recorded for asymptomatic subjects. There was no significant difference in all the haematological parameters of the acute and chronic infected subjects, although both recorded abnormally high ESR, and WBC count; but low Hb concentration, RBC count and HCT value. No haematological malignant cells was recorded in the peripheral blood of the subjects, although the HBV infected subjects showed significant (P<0.05) peripheral blood picture of Atypical Mononuclear cells, Reactive Lymphocytes and RBC hypochromasia compared to the uninfected subjects. It is recommended that education on prevention of HBV infection be intensified to help reduce the high prevalence rate revealed by the study. Also as part of the management of HBV infected patients, routine haematological investigations should be carried out, particularly for symptomatic HBV infected patients as well as acute and chronic patients, to help remedy the likely haematological abnormalities that they may present, in order to enhance their overall effective management.
A thesis submitted to the Department of Clinical Microbiology, K NUST, in partial fulfillment of the requirements for the award of a degree of MPHIL. Clinical Microbiology,