Anamnestic Findings and Alanine Aminotransferase Predict Accurately Chronic HBs Antigen Carriers among Black Africans in Côte d’Ivoire (West Africa)

Background: The high burden of viral hepatitis B (HBV) remains a challenge in Cote d’Ivoire where patients are mostly seen in hospital at the end stage of the disease. Aim: This cross sectional study is aimed at assessing the usefulness of anamnestic findings, clinical and biological factors in predicting chronic hepatitis B surface antigen (HBsAg) carriers in clinical practice. Patients and methods: The study was conducted in 230 workers (median age: 39 years, female: 20%) of government press enterprise (GPE) in 2010. Socio-demographic, clinical and biological parameters were collected. Chronic HBsAg carrier was defined as serum HBsAg positivity after 2 assessments within 6 months interval. Diagnostic accuracy of predictive factors was determined by multivariate logistic regression. Results: The prevalence of chronic HBsAg was 12.6% [95%CI: 8.61-17.60]. Chronic HBsAg carriers frequently expressed a history of hepatitis (13.8 vs 2.5%, p=0.003), or jaundice (37.9 vs 14.3, p=0.003), had slightly high level of AST (33 vs 25.5 IU/L, p=.004) and ALT (31.5 vs 22, p= 0.5, the model showed a specificity, positive and negative predictive values of 99, 66.7 and 88.9% respectively. The model correctly classified 192(99%) workers as non-chronic HBsAg carriers and 2(1%) were misclassified. Conclusion: This study suggests that age, history of hepatitis, unsafe injection with boiled syringe combined with ALT could be used to predict chronic HBsAg carrier in Cote d’Ivoire and other endemic areas in Africa.