High prevalence of alpha 1 antitrypsin phenotypes in viral hepatitis B infected patients in Iran

Abstract: Objective: Hepatitis B virus (HBV) infection is a major global public health problem. Approximately 2 billion people are infected worldwide and more than 350 million of these individuals are chronic carriers of HBV. Approximately 15–40% of infected patients will develop cirrhosis, liver failure, or hepatocellular carcinoma (HCC). Alpha 1 antitrypsin (AAT) deficiency is one of many factors that may be involved in abnormalities such as liver and lung disease, inflammatory joint diseases, and inflammatory eye diseases. In the present study, the role played by AAT in HBV infected individuals is analyzed. Methods: AAT phenotyping and trypsin inhibitory capacity (TIC) experiments were performed on 281 HBV infected patients who were referred to Tehran and Zahedan Hepatitis Center for a period of 3 years from June 2001 to September 2003. The same tests were performed on 257 individuals who did not suffer from any systemic diseases (control group). The case group was subdivided into three groups: carrier (36.7%), chronic (50.5%), and cirrhotic (12.8%). Results: The results showed that AAT phenotypes, MS, MZ, M1Z, and M1S, were significantly higher in the HBV group (p <0.01). In addition, there was a significant difference in AAT phenotypes (MS, MZ, and M1Z) among inactive carriers and individuals in the chronic and cirrhotic group (p <0.001). Conclusions: There is a high prevalence of moderate AAT (MS, M1S, and MV) and severely deficient (MZ and M1Z) phenotypes in Iranian HBV individuals. In addition, AAT deficiency might be a risk factor for infected HBV individuals progressing from the carrier stage to chronic and cirrhotic stages. [Copyright &y& Elsevier]