A Study of chronic Hepatitis in northern India

Singh, D.S., Lecturer in Medicine, Jawaharlal Institute of Post-graduate Medical Education and Research, Pondicherry. Sama, S.K., Consultant Gastroenterologist, Sir Ganga Ram Hospital, New Delhi. and Singh, G., Senior Technician, Department of Gastroenterology, All-India Institute of Medical Sciences, New Delhi, India.

Hepatitis B antigen positive and HBAg negative chronic hepatitis might be aetiologically distinct entities. The study of auto-antibodies in relation to HBAg in chronic hepatitis patients also support this hypothesis. While smooth muscle antibodies and anti-nuclear antibodies have been reported in over 50 per cent cases of chronic hepatitis from Great Britain, and U.S.A. in the present study only one case had both positive antinuclear factor and HBAg. Similarly, the rarity of auto-antibodies in antigen positive chronic liver disease have been published from USA, Great Britain, Greece and Switzerland (Prince et al., 1970; Blumberg et al., 1970; Fox et al., 1969; Hadziyannis et al., 1970; and Reinicke and Nordenfelt, 1970).

While the role of steroids and immunosuppressive drugs like 6 mercaptopurine (6 M.P.) and azathioprine (imuran) is well established in chronic active hepatitis (Mistilis, and Blackburn, 1967; Cook et al., 1971), its value in HBAg positive chronic hepatitis needs to be evaluated by prospective double blind trials. Persistent antigenaemia beyond 12 weeks observed in this study appears to be the most important antecedent factor in predicting chronic course in patients of acute viral B hepatitis.


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