Beyond HBsAg Positivity: A Genotype-Resolved View of Hepatitis B Clinical and Serologic Diversity in Pakistan

Abstract

Hepatitis B Virus (HBV) remains a major contributor to chronic liver disease, cirrhosis, and hepatocellular carcinoma. Pakistan is considered an intermediate-burden country with heterogeneous regional prevalence and genotype distribution. This study summarizes clinical, demographic, serological, and treatment-related patterns in a Pakistani HBV dataset and interprets the findings in the context of known genotype distribution in Pakistan. De-identified electronic health-record data were reviewed for age, gender, Body Mass Index (BMI), disease duration, smoking status, treatment response, adverse effects, and HBV markers, including Hepatitis B surface Antigen (HBsAg), Hepatitis B e Antigen (HBeAg), Hepatitis B e Antibody (HBeAb), Hepatitis B core Immunoglobulin M (HBc IgM), and Hepatitis B surface Antibody (HBsAb). Descriptive analysis showed a mean age of 45.3 years, near-balanced gender distribution, mean BMI of 27.5 kg/ m2, and mean disease duration of 12.7 years. Smoking was reported in 35% of the study population. HBsAg positivity was 1.85%, whereas HBeAg positivity was 21.62%, suggesting an important active replication subgroup among those tested. HBeAb and HBsAb positivity were each 18.92%, and HBc IgM positivity was 13.51%, indicating a mixture of immune, active, and recent-infection signals. Correlation analysis highlighted strong relationships between age and age of onset, and between weight and BMI. Systemic antiviral care showed a modestly higher mean response score than supportive/local care, while most adverse effects were mild or moderate. These findings underscore the need for improved vaccination, early diagnosis, confirmatory molecular testing, genotype-aware surveillance, and long-term management of chronic HBV in Pakistan.

Keywords: Hepatitis B Virus; Pakistan; HBsAg; HBeAg; Genotype D; Serology; Epidemiology; Clinical Correlates

Citation

Rehan Uppal M, Uppal R, Saeed U, Saad Uppal M, Zahid Piracha Z. Beyond HBsAg Positivity: A Genotype Resolved View of Hepatitis B Clinical and Serologic Diversity in Pakistan. WebLog J Community Med. wjcm.2026. h2902. https://doi.org/10.5281/zenodo.22499270