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Demographic characteristic of patients and controls recruited in the study are shown
on Table 1.

Table 1. Demographic characteristics of study participants (N = 131)

Comparison of AST and ALT levels in HBV cases and healthy controls

The mean alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels
were significantly higher (p  0.001) in HBV infected patients than healthy controls.
However, these values (AST: 16.69 ± 6.88 SD and ALT: 15.39 ± 7.08 SD) were significantly
lower than upper limits of the test kits (AST ? 19 IU/ml, ALT ? 22 IU/ml). After adjusting
for age and sex, AST (p = 0.001) and ALT (p  0.001) were still higher in HBV infected
cases than controls (Table 2).

Table 2. Comparison of mean ALT and AST levels between HBV infected cases and controls

Generally, abnormal AST levels (M  19, F  16 IU/ml) were common in HBV infected
cases than controls (35.8 vs 10 %, p = 0.001). Similarly, abnormal (M  22, F  18 IU/ml)
ALT level was higher in infected cases than controls (17.3 vs 2 %, p = 0.008).

Viral load and genotype distribution

Of the 81 HBV infected cases viral load was detected in 76 (93.8 %) with mean viral
load of 120,807 IU/ml with a standard deviation (SD) of ± 440,159 IU/ml (range 14–2,664,237)
while 5 (6.2 %) of the participants had undetectable viral load. Eleven (14.5 %) of
the patients had viral load ?20,000 IU/ml (mean 826,715 ± 901,130 SD), while 65 (85.5 %)
had viral load 20,000 IU/ml (mean 1345 ± 2775 SD).

Genotyping was performed on HBV patients with detectable viral load. The identified
genotypes in order of prevalence were A (47.4 %), E (39.5 %), C/E (3.9 %) A/C (2.6 %),
A/E (2.6 %), B (1.3 %), A/B (1.3 %) and B/C (1.3 %).
Genotypes A and E were more prevalent (p = 0.034) in South West and North West region
respectively. Age and gender distribution across the predominant genotypes A and E
are stated on Table 3. Amongst all the mixed genotype infections, only A/E was found in the North West
Region of Cameroon (Table 4).

Table 3. Gender and age distribution among genotype A and E infected persons

Table 4. Distribution of HBV genotype cases based on patient address

There was a significant difference in mean viral load of patients among the different
genotypes (p = 0.031) with genotype E having the highest mean viral load. Male patients
as well recorded a significantly higher mean viral load vis-à-vis female patients
(p = 0.022) (Table 5). Similarly, patients with elevated AST (p = 0.002) and ALT (p  0.001) levels had
significantly higher viral loads than those with normal enzyme levels.

Table 5. Comparison of mean viral load in the age groups, sex, HBV genotypes, ALT and AST levels

Both mean AST and ALT levels were significantly higher in patients with viral load
?20,000 IU/ml when compared to those with viral load levels 20,000 IU/ml. Likewise,
AST levels were significantly higher in patients infected with genotype E when compared
to A and others (Table 6). Viral load correlated significantly with ALT (? = 0.425, p  0.01) and AST (? = 0.272,
p = 0.018).

Table 6. Comparison of mean ALT and AST levels among the genotypes and viral load categories