Gastroenterologia Japonica
3
Copyright 9 1991 by The Japanese Society of Gastroenterology
Hepatitis B and C virus infection in Ujung Pandang, Indonesia
Rifai AMIRUDIN t, Ham AKIL, Yoshihiro AKAHANE 2, and Hiroshi SUZUKI 2
1Division of Gastroenterology, Department of lnternal Medicine, Faculty of Medicine, Hasanuddin University,
Ujung Pandang, Indonesia; and 2First Department of Internal Medicine, Yamanashi Medical College,
Yamanashi, Japan
Introduction
Recently a blood-borne NANB agent, designated
hepatitis C virus (HCV) has been isolated and
characteristized. The frequency of HCV infection
has been reported from different groups in many
countries.
In order to evaluate the etiological significance
of H A V , HBV, and HCV infection in various
liver diseases in Ujung Pandang, Indonesia, we
assayed several viral markers in sera from patients
with liver diseases and voluntary blood donors.
In addition, we studied the magnitude of HBV
and HCV infection in various liver diseases in
Eastern Indonesia.
Materials and M e t h o d s
Four hundred and six samples of sera from pa-
tients with acute and chronic liver diseases from
several hospitals in the Ujung Pandang area, and
voluntary apparently healthy blood donors were
tested for HBsAg (RPHA, EIA), anti-HBs
(PHA), anti-HBc (HI), HBeAg/anti-HBe (EIA),
anti-HCV (EIA-ORTHO), IgM anti-HA, IgM
anti-HBc (EIA) and HBsAg subtypes (EIA).
All samples of sera were collected from March
1990 until mid-October 1990 and brought to
Japan for assays in the Division of Hepatology,
First Department of Internal Medicine, Yama-
nashi Medical College.
Gastroenterol Jpn 1991:26(Suppl 3)184-188
Address for correspondence: Rifai Amirudin, M.D., Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine,
Hasanuddin University, Ujung Pandang, Indonesia.
Vol. 26, Suppl.
Printed in Japan
Results
The 406 serum samples came from 196 blood do-
nors (BD), 78 cases of acute hepatitis (AH), 43
cases of chronic hepatitis (CH), 58 cases of liver
cirrhosis (LC), 31 cases of hepatocellular carci-
noma (HCC).
The prevalence of HBsAg in voluntary blood
donors was 7.1%. The age-specific distribution
of HBsAg showed that the prevalence among the
30-39 age group was 2.6%, and reached a peak in
the 40-49 age group (12.5%). The hepatitis sur-
face antibody was detected in 52 out of 196 blood
donors, a prevalence of 26.5%.
Anti-HBs was defected in 42.9% among the 20-
29 age group, and declined to 17.1% in the 15-
19 age group and again increased to 35% in age
groups 30 and over.
The prevalence of anti-HCV in voluntary blood
donors was 3.1%.
In acute viral hepatitis, 18 (23.1%) cases were
hepatitis A, 8 (10.3%) cases were hepatitis B and
37 (47.4%) cases were non-A, non-B hepatitis.
One case was considered to be double infection
of H A V and HBV.
Sixteen (20.5%) cases were acute exacerbation
of HBV carrier, of which 6 (37.5%) cases were
positive for anti-HCV.
Among patients with non-A, non-B hepatitis,
3 (8.1%) cases were positive for anti-HCV.
The prevalence of H C V antibody was 1~1.5%
among acute viral hepatitis cases.
Among patients with chronic liver diseases,
July 1991 H B V and H C V infection in Ujung Pandang, Indonesia 185

Table 1 Detection of hepatitis viral markers in blood donors in Ujung Pandang, Indonesia

Age group n anti-HCV (+) ve HBsAg (+) ve anti-HBs (+) ve anti-HBc (+) ve All negative*
-19 70 2 (2.9) 5 (7.1) 12 (17.1) 41 (58.6) 25 (35.7)
20-29 28 1 (3.6) 2 (7.1) 12 (42.9) 23 (82.5) 6 (21.4)
30-39 38 0 1 (2.6) 9 (23.7) 31 (87.6) 7 (18.4)
40-49 40 2 (5.0) 5 (12.5) 12 (30.0) 35 (87.5) 2 (5.0)
50-59 20 1 (5.0) 1 (5.0) 7 (35.0) 19 (95.0) 2 (10.0)
Total 196 6 (3.1) 14 (7.1) 52 (26.5) 149 (76.0) 42 (21.4)
*negative HBV and HCV markers ( ):%

Table 2 Detection of viral markers in sera from patients with

acute viral hepatitis in Ujung Pandang, Indonesia

IgM HBsAg IgM n=78 Diagnosis anti HCV

anti-HA anti-HBc
(+) (-)
+ - - 15 A 0 17
+ + - 2

+ - + 1 A+B 0 1

- + + 7
- - + 0
- + - 16
37
*HBV carrier + NANB or acute exacerbation
31.1% were positive for hepatitis surface antigen,
32.6% were positive for anti-HCV and 10.6%
were positive for both markers.
The positive rate of HBsAg was 25.6% for
chronic hepatitis, 32.8% for liver cirrhosis and
35.5% for hepatocellular carcinoma, while the
rate for anti-HCV were 16.3%, 43.1% and 35.5%
respectively. The overall rate of chronic liver
diseases negative for both markers was 46.9%.
The prevalence of HBeAg in hepatitis B sur-
face antigen-positive serum samples among blood
donors and cases of chronic hepatitis, liver cir-
rhosiS, hepatocellular "carcinoma was 35.7%,
27.3%, 31.6% and 9%, while that for anti-HBe
was 42.6%, 45.5%, 57.9% and 72.7%.
In this study the HBeAg-positive, anti-HBe-
positive rates were 27.3% 54.5%, while 18.2%
were negative for both markers.
B 0 7
Fig. 1 Detection of HBsAg and anti-HCV in sera from patients
with chronic liver diseases in Ujung Pandang, Indonesia.
?* 6 10
(38%)
In acute hepatitis the prevalence of HBsAg
NANB 3 34
(8%) subtypes, adr, adw, adyw were 54.5%, 18.1%
and 27.3% respectively.
However, in blood donors and chronic liver
diseases adw, adr, adyw, and adywr were 48.4%,
38.7%, 9.6% and 3.2% respectively.
In the present study adr was 45.5%, followed
by adw (35.8%).
Discussion
The prevalance of HBsAg, particularly in blood
donors in various populations has been reported
to range from 10-15% in Africa and Asia 5'9. In
Indonesia the prevalence of HBsAg among vol-
untary blood donors was 5.5% (range 3.5-9.1%)
and in Ujung Pandang it was 6.4% 6. In this study
the rate was 7.1%, slightly higher the previous
prevalence.
Differences in the prevalence of HBsAg in
various populations may be due to intrafamilial
spread of infection, low socioeconomic condi-
tions, various infectious diseases, race or genetic