Seroprevalence of HBsAg in antenatal women was found to be 0.9%. HBe-antigen and HBV DNA positivity was associated with a higher chance of vertical transmission.

Background/Aims:Minimal hepatic encephalopathy (MHE) implies subtle impairment of cognitive functions in the absence of features of overt encephalopathy. We aimed to determine the prevalence of MHE in patients with liver cirrhosis and to find out the effect of rifaximin, probiotics, and l-ornithine l-aspartate (LOLA) individually in reversal of MHE by comparing it with placebo group.Patients and Methods:This study was carried out in two phases. Phase I included the recruitment of 250 apparently healthy controls and extraction of normative data utilizing three neuropsychometric tests (NPTs) and critical flicker frequency (CFF) test. Phase II consisted of screening and recruitment of patients of MHE followed by drugs trial. A total of 317 cirrhotics were screened; 111 were excluded and the remaining 206 cirrhotics were screened for MHE using NPTs and/or CFF test. Of these, 124 patients with MHE were randomized to receive LOLA (n = 31), rifaximin (n = 31), probiotics (n = 32), for 2 months and were compared with patients who were given placebo (n = 30).Results:Out of 206 cirrhotics, 124 (60.19%) had MHE. Among these 124 MHE patients, 87 (70.16%) patients had CFF <39Hz, 112 (90.32%) patients with MHE had two or more abnormal NPTs, and 75 (60.48%) patients had abnormality on both the CFF values and more than two abnormal NPTs. Intention-to-treat analysis showed the number of patients who improved after giving treatment were 67.7% (21/31), 70.9% (22/31), 50% (16/32), and 30% (9/30) for LOLA, rifaximin, probiotics, and placebo, respectively. CFF scores and improvement in psychometric tests after treatment were significantly higher (P < 0.05) for LOLA, rifaximin, and probiotics as compared with placebo group.Conclusions:Prevalence of MHE is high in patients with cirrhosis of liver. Rifaximin, LOLA, and probiotics are better than giving placebo in patients with MHE.

Transient neurological changes occurring in patients suffering from hepatic precoma and coma are well known (Adams and Foley, 1953;Summerskill et al., 1956). The development of permanent neurological deficits in such patients has only recently been appreciated. It is becoming increasingly clear that permanent neurological changes referable to many systems are not uncommon in these patients. During the past five years R. D. Adams and M. Victor (personal communication, 1962) Investigations revealed normal urinary findings and a nearly normal haemogram, with Hb 10 g./100 ml., W.B.C. 6,900/c.mm., and E.S.R. 15 mm. in first hour. No megaloblasts were seen in the bone-marrow smears. Free acid was present in the aspirated gastric juice. The total serum proteins were 6 g./100 ml. (albumin 2.2 g., globulin 3.8 g.