‫بسم هللا الرحمن الرحيم‬

‫{َو َم ا َتْو ِفيِقي ِإَّال ِباِهَّلل َع َلْيِه َتَو َّك ْلُت َو ِإَلْيِه ُأِنيُب {‬
‫صدق هللا العظيم‬

‫(‪)88‬‬ ‫سورة هود ‪ /‬اآلية‬

‫اإلهداء‬
‫‪ُ:‬نهدي ثمرة ُج هدينا المتواضع‬
‫إلى من وهبنا الحياة واألمل‪ ،‬والنشأة على شغف االطالع‬
‫والمعرفة‪ ،‬ومن علمنا أن نرتقي ُس ًلم الحياة بحكمة وصبر؛‬
‫برًا‪ ،‬وإحسانًا‪ ،‬ووفاًء لهم‬
‫والدينا‬
‫‪I‬‬
 ‫إلى من وهبنا هللا نعمة وجودهم في حياتينا إلى العقد المتين‬
‫من كانوا عونًا لنا في رحلة بحثنا‬
‫إخواننا وأخواتنا‬
‫و أخيًر ا إلى كل من ساعدنا‪ ،‬وكان له دور من قريب أو بعيد‬
‫في إتمام هذه الدراسة‪ ،‬سائلين المولى عزه وجل أن يجزي‬
‫الجميع خير الجزاء في الدنيا واألخرة‪.‬‬
‫تم إلى كل طالب علم سعى بعلمه‪ ،‬ليفيد اإلسالم والمسلمين‬
‫بكل ما أعطاه هللا من علم ومعرفة‪.‬‬

‫شكر وتقدير‬

‫في البداية نحمد هللا عّز وجل الذي وفقنا في إتمام ّهذا البحث‬
‫العلمي‪ ،‬والذي ألهمنا الصّح ة والعافية والعزيمة‬
‫فالحمد هللا حمدًا كثيرًا‪.‬‬
‫قال تعالى‪َ{ :‬و َفْو َق ُك ِّل ِذ ي ِع ْلٍم َع ِليٌم } سورة يوسف آية (‪)76‬‬
‫وق‪KK‬ال رس‪KK‬ول هللا "ص‪YY‬لى هللا علي‪YY‬ة وسلم") من ص‪َKK‬نع ِإليكم‬
‫َم ْعُر وفًا َفَك اِفُئوه‪َ ،‬فِإن لم َتِج ُدوا ما ُتَك اِفُئوَنُه ِبه َفْادعْو ا َلُه حَّتى‬
‫َتُر وا َأنُك م َك اَفْأُتم " (رواه أبو داوود"‬

‫نقدم بجزيل الشكر والتقدير إلى الدكتور الفاضل‪ :‬عبد العزيز‬

‫الدرهوبي لقبوله االشراف على بحثنا وعلى كل ما قدمه لنا‬
‫من توجيهات ومعلومات قيمة ساهمت في إثراء موضوع‬
‫دراستنا في جوانبها المختلفة‪.‬‬

‫‪II‬‬
 ‫وما توفيقنا اال من عند هللا‬
‫طالبات البحث‬
ABSTRACT
Aims: To investigate the association of gamma-glutamine transferase
(GGT) levels in hepatitis B patients.
Materials and Methods: Study performed was conducted on a sample
of cases infected with HBV and the sample of the study is represented by
the number of "100" males and females in the from different age groups,
data was collected from the medical laboratories of the "Infectious
Diseases Department' Tripoli Central Hospital, duration was four months
in 2022 from ''April to July months ''.
Results: Correlation between γ-Glutamyl Transferase (γ-GT) test
during and after Treatment of HBV infection the test of the Chi- square
shows that the sig. value was P > 0.005, a statistical indication that there
is a relationship between the γ-GT test and cirrhosis of the liver for cases.
Conclusion: In conclusion, it is proposed that in patients with chronic
viral hepatitis, GGT levels can be taken into consideration to predict
advanced histological liver damage, especially in patients with hepatitis
B.
Recommendation: We recommend that a GGT test be performed when
a viral hepatitis infection is detected immediately.

III
 List of Contents
1. INTRODUCTION...................................................................................................
2. LITERATURE REVIEW........................................................................................
2.1. LIVER...................................................................................................................
2.2. VIRAL HEPATITIS.............................................................................................
2.3. HEPATITIS B VIRUS..........................................................................................
2.4. LIVER CYCLE HBV...........................................................................................
2.5. TRANSMISSION.................................................................................................
2.5.1. Perinatal Transmission......................................................................................
2.5.2. Sexual Transmission.........................................................................................
2.5.3. Parenteral/percutaneous Transmission..............................................................
2.6. EPIDEMOLOGY..................................................................................................
2.6.1. High-Prevalence Populations............................................................................
2.6.2. Intermediate-Prevalence Prevalence...............................................................10
2.6.3. Low-Prevalence Populations...........................................................................11
2.7. PREVLOUS STUDIES......................................................................................12
2.8. PATHOGENESIS...............................................................................................13
2.8.1 HBV Infection and Development of Hepatocellular carcinoma......................14
2.9. SYMPTOMS AND SIGNS................................................................................15
2.10. DIAGNOSIS.....................................................................................................18
2.10.1. Laboratory diagnosis.....................................................................................18
2.10.2. Gamma Glutamyl Transferase......................................................................20
2.11. TREATMENT..................................................................................................21
2.12. prevention.........................................................................................................23
2.12.1. Behavior Modification..................................................................................23
2.12.2. Passive Immunoprophylaxis.........................................................................23
2.12.3. Active Immunization.....................................................................................24
2.13. SURVEILLANCE AND CONTROL...............................................................24
2.13.1. Hepatitis B disease surveillance procedures should include ........................24
2.13.2. Hepatitis B disease control measures should include...................................24

IV
3.1. STUDY DESIGN...............................................................................................27
3.2. EQUPMENTS ...................................................................................................27
3.3. REAGNT ...........................................................................................................27
3.3.1. PRINCIPLE.....................................................................................................28
3.3.2. COMPOSITION REAGENTS.....................................................................28
3.3.3. SAMPLE COLLECTION................................................................................28
3.3.4. STORAGE AND STABILITY.......................................................................28
3.3.5. PROCEDURE..................................................................................................28
3.3.6. NORMAL RENGE..........................................................................................28
3.11. DATA ANALYSIS METHODS......................................................................28
4.1. RESULT............................................................................................................31
Axis I: - study sample data........................................................................................31
Axis II: Descriptive Statistics....................................................................................34
Axis III: Link and Decline........................................................................................37
4.2. DISCUSSION....................................................................................................38
4.3. RECOMMENDATION................................................................39 REFRENCE
40

V
 List of Figures
NO Title Page
1 Liver location 4
2 Inflammation of the liver 5
3 Types viral hepatitis B 5
4 Structure of hepatitis B 6
5 Hepatitis B viral life cycle 7
6 Global prevalence of hepatitis B virus infection 9
7 Show chronic hepatitis, liver cirrhosis and hepatocellular 13
carcinoma
8 Show possible pathogenesis of HBV infection and liver disease. 15
CTL, cytotoxic T- lymphocyte; HBV, hepatitis B virus ; NK,
natural killer ; SPLK, serine protease inhibitor Kazal
9 Show yellow color of the eye 16
10 Show Abdominal pain 16
11 Show Fever 16
12 Enlarged liver due to hepatomegaly 16
13 Enlarged spleen and liver (hepatosplenomegaly) in most affected 17
children
14 Show Gamma-glutamyltransferase 20
15 How Gamma-GT works: the enzyme gamma-glutamyl 21
transferase in the cell membrane splits glutamyl and transports
the amino acid cysteine into the cell interior
16 Distribution of gender among HBV patients 31
17 Distribution of age gender between HBV patients 32
18 Show the frequency and percentage of social stat among HBV 33
patients
19 Show distribution of age group between HBV patients 34
20 Show the frequency and percentage of distribution by address of 34
Pt. among HBV patients Outside Tripoli
21 different between the liver function test in first diagnosis and 35
during 3 months of treatment
22 Show the descriptive statistics (mean) for liver cirrhosis 36

VI
 List of Tables
NO Title Page
1 Show the distribution of gender among HBV patients 31
2 Distribution of Age group between HBV patients 32
3 Show the frequency and percentage of social stat among HBV 33
patients
4 Frequency and percentage of distribution of address of Pt. among 33
HBV patients
5 Show descriptive statistic of liver function test among HBV Pt. in 35
first diagnosis and during 3 month of treatment
6 Descriptive statistic of liver function test among HBV Pt. for 36
liver cirrhosis
7 Show descriptive statistic of liver stage of cirrhosis among HBV 36
.Pt
8 Show the Correlation between - Glutamyl Transferase (- GT) 37
test during and after Treatment of HBV infection

VII
 List of Abbreviations
Complete Name Abbreviation
Alkaline phosphatase ALP
Alanine Transaminase ALT
Aspartate Aminotransferase AST
covalently closed circular DNA cccDNA
Chronic hepatitis B CHB
Complete response CR
Cytotoxic T lymphocyte CTL
endoplasmic reticulum ER
grams per deciliter g/dl
Gamma-Glutamel Transferase GGT
Hepatitis B HB
Hepatitis B core Antigen HBcAg
hepatitis B e antigen HBeAg
Hepatitis B Foundation HBF
Hepatitis B Immune Globulin HBIG
hepatitis B surface antibody HBsAb
Hepatitis B surface antigen HbsAg
Hepatitis B Virus HBV
Hepatocellular Carcinoma HCC
Human leukocyte antigens HLA
inactive carrier IC
immune tolerance IT
International units per liter IU/L
kilobase kb
milligrams per deciliter mg/dl
natural killer NK
polymerase chain reaction PCR
prothrombin time PT
people who inject drugs PWID
serine protease inhibitor Kazal SPIK
Sexually transmitted disease STD
units per liter U/L

VIII
upper limit of normal ULN
World Health Organization WHO

IX