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Hepatitis B viral infection could be complicated by hepatocellular degeneration, liver cirrhosis, and cancer. A total of 87 participants – 29 each of symptomatic and asymptomatic hepatitis B positive, and hepatitis B negative individuals (controls) – were recruited, and their serum samples were evaluated for serum telomerase (a biomarker for cell aging and tumorigenesis), alpha fetoprotein, and liver enzymes. Serum telomerase of the symptomatic group was higher than that of the asymptomatic group and the control ( P  &lt; .001). Serum α-fetoprotein in the symptomatic group was also higher than the asymptomatic group and the controls ( P  &lt; .001). The mean AST value for the symptomatic test group was higher than the asymptomatic test group and the control ( P  &lt; .001). The mean ALT value for the symptomatic test group was higher than the asymptomatic test group and the control ( P  &lt; .001). However, serum α-fetoprotein, AST, and ALT in the asymptomatic group were not significantly different from the controls. Serum telomerase activity was higher in symptomatic and asymptomatic HBV subjects compared with controls; this provides better information than AFP and liver enzymes that were only higher in symptomatic subjects. Serum telomerase activity could therefore be used as a marker in predicting the onset of hepatocarcinogenesis. Abbreviation list HBV: Hepatitis B virus; AFP: Alpha fetoprotein; ALT: Alanine transaminase; AST: Aspartate transaminase; HCC: Hepatocellular carcinoma; ELISA: Enzyme-linked immunosorbent assay; CLD: Chronic liver disease; CMV: Cytomegalovirus; TERT: Telomerase reverse transcriptase; TERC: Telomerase RNA component; WHO: World Health Organization; BUHREC: Babcock University Health Research Ethics Committee; CTL: Cytotoxic T-lymphocyte

Prognostic significance of serum telomerase activity in the monitoring of hepatitis B viral infection