RESUMO
Recent reports show that the frequency of HBsAg varies around 4 to 6% in most Mediterranean and Middle East countries. Those areas are therefore considered as areas of intermediate endemicity for hepatitis B virus (HBV) infection. The purpose of this study is to investigate the HBV global situation in Tunisia, by means of third generation testing methods. Blood samples were obtained from 3 distinct population groups from Tunis: blood donors, consisting of young male adults staff members and patients from 4 haemodialysis units patients with either acute hepatitis or liver cirrhosis They were tested for HBsAg, anti-HBs and anti-HBc by radioimmunoassay tests. HBsAg was detected in 6.5% of the young male adults, and approximately 60% had either anti-HBs or anti-HBc antibodies. Haemodialysis staff members and patients respectively displayed 9.1% and 19.5% of HBsAg positivity, but an increase of HBsAg positivity and of all HBV serum markers in relation to the amount of time spent in dialysis units was shown among the patients. After 3 years of dialysis sessions, none remained seronegative. HBsAg was detected in approximately two-thirds of the patients with acute hepatitis or liver cirrhosis, and all cirrhosis patients had at least one HBV serum marker. These global results stress the importance of HBV infection in Tunisia. Immunization against hepatitis B virus therefore has to be considered. Nevertheless, the immunization strategy must take into account the epidemiological and economic characteristics of the country.