Анотація
Background and Aim: Globally, hepatitis B virus (HBV) infection has been a major public health issue. In sub-Saharan Africa, about 10-20% of the general population are chronic carriers of HBV infection thus, making it a high endemic region. This study was designed to evaluate the pattern of distribution of markers of HBV among asymptomatic subjects in an urban community in southwest Nigeria.
Methodology: The study was carried out among apparently healthy subjects without prior knowledge of their HBV status. A structured questionnaire was used to collect demographic and relevant information while ELISA kits were used to detect HBsAg/Ab, HBeAg/Ab, Total antiHBc and antiHBc IgM using the participants’ sera.
Results: The results of 438 subjects comprising, 133 (30.4%) males and 305 (69.6%) females were analysed, age ranged 1.5-70 years (35.7±15.7 years). Overall, 31 (7.1%) of the participants had detectable HBsAg, 2 (6.5%) and 7 (1.6%) subjects had detectable HBeAg and anti-HBc IgM respectively. Anti-HBs was detected in 83(18.9%) subjects, while 39 (8.9%) had anti-HBe. Of the HBsAg positive participants, 1 (3.2%) of them was also positive for both anti-HBc IgM and HBeAg, 25 (80.6%) had antiHBe while 3 (9.7%) had only anti-HBc IgM. None of them had antiHBs. Among those who were HBsAg negative, 83 (20.4%) had anti-HBs as the only serological marker, while 313 (76.9%) had no serological markers of HBV infection. Only 145 of the total population were tested for anti-HBc Total, of whom 65(44.8%) were positive.
Conclusion: This study has highlighted the burden of HBV infection in the population studied. There is therefore, the need for more awareness through information programmes to the public and for preventive measures through vaccination programmes.
Keywords: HBV infection, Serological markers, Urban, Southwest Nigeria
Résumé
Contexte et objectif : À l’échelle mondiale, l’infection par le virus de l’hépatite B (VHB) a été un problème majeur de santé publique. En Afrique subsaharienne, environ 10 à 20% de la population générale sont donc porteurs chroniques de l’infection par le VHB, ce qui en fait une région fortement endémique. Cette étude a été conçue pour évaluer le modèle de distribution des marqueurs du VHB chez les sujets asymptomatiques dans une communauté urbaine du sud-ouest du Nigéria.
Méthodologie : L’étude a été menée auprès de sujets apparemment sains sans connaissance préalable de leur statut VHB. Un questionnaire structuré a été utilisé pour collecter des informations démographiques et pertinentes tandis que des kits ELISA ont été utilisés pour détecter HBsAg / Ab, HBeAg / Ab, Total antiHBc et antiHBc IgM en utilisant le sérum des participants.
Résultats : Les résultats de 438 sujets comprenant 133 (30,4%) sujets masculins et 305 (69,6%) sujets féminins ont été analysés, l’âge variait de 1,5 à 70 ans (35,7 ± 15,7 ans). Dans l’ensemble, 31 (7,1%) des participants avaient un HBsAg détectable, 2 (6,5%) et 7 (1,6%) sujets avaient respectivement un HBeAg détectable et un IgM anti- HBc. AntiHBs a été détecté chez 83 (18,9%) sujets, tandis que 39 (8,9%) avaient anti- HBe. Parmi les participants positifs pour HBsAg, 1 (3,2%) d’entre eux était également positif pour IgM anti- HBc et HBeAg, 25 (80,6%) avaient antiHBe tandis que 3 (9,7%) n’avaient que IgM anti- HBc. Aucun d’eux n’avait d’antiHB.Parmi ceux qui étaientnégatifs pour AgHBs, 83 (20,4%) avaient des anti-HBs comme seul marqueur sérologique, tandis que 313 (76,9%)n’avaient aucun marqueur sérologique d’infection par le VHB.Seulement 145 de la population totale ont été testés pour le total anti-HBc, dont 65 (44,8%) étaient positifs.
Conclusion :Cette étude amis en évidence la charge de l’infection par le VHB dans la population étudiée.Il est donc nécessaire de sensibiliser davantage le public par des programmes d’information et de prendre des mesures préventives par le biais de programmes de vaccination.
Mots-clés : infection par le VHB, marqueurs sérologiques, urbain, sud-ouest du Nigéria
Correspondence: Dr. S.B. Bakarey, Institute for Advanced Medical Reseach and Traing, College of Medicine, University of Ibadan, Ibadan, Nigeria. Email:drbakarey@yahoo,com.
Посилання
World Health Organization. Hepatitis B Fact Sheet No. 204. 2009. Available at http://www.who.int/csr/disease/hepatitis
World Health Organisation. Epidemiological Update:Increasing Mortality Calls For Action. Global Hepatitis Report 2017 pp 8. ISBN 978-92-4-156545-5
Hudson CP. How AIDS forces reappraisal of hepatitis B virus control in sub-Saharan Africa. Lancet 1990;336:1364-1369
Beasley RP and Hwang LY. Epidemiology of hepatocellular carcinoma. In Vijas GN, Dienstag JL, Hoofnagle JH (eds): viral hepatitis and liver disease. Grune and Stratton, Orlando, Florida 1984;2009-14
McMahon BJ, Alward WL, Hall DB, et al. Acute hepatitis B virus infection: relation of age to clinical expression of disease and subsequent development of the carrier state. J Infect Dis 1985;151:599-603
Clement CJ, Kane M, Hu DJ, Kim-farley R et al. Hepatitis B vaccine joins fight against pandemic disease. World Health Forum 1990;11:165-168
Kire CF. The epidemiology and control of hepatitis B in sub-Saharan Africa. Prog Med Virology 1993;40:143-156
Gerlich, W.H. Medical Virology of Hepatitis B: How it began and where we are now. Virol J. 2013;10:239.DOI: 10.1186/1743-422X-10-239.
Yakubu AM, Okuonghae HO and Angyo IA. Prevalence of hepatitis B surface antigen in children with sickle cell anaemia. J Trop Paed 1998;13:376-377
Fakunle YM, Abdulrahman MB and Whittle AC. Hepatitis B virus infection in children and adults in Northern Nigeria, a preliminary survey. Trans R Soc Trop Med Hyg. 1981;75:626-629
Ukaeje CJ, Ogbu O, Inyama PU, Anyanwu GI and Njoku MO. Prevalence of hepatitis B surface antigen among blood donors and human immunodeficiency virus infected patients in Jos, Nigeria. Mom do inst Oswaldo Cruz 2005;100:13-16
Abiodun PO, Flach KH and Omoike IU. Hepatitis and sickle cell anaemia. Nig J Paed. 1986;13:95
Ezegbudo CN, Agba MI, Agbonlahor DE, et al. The seroprevalence of hepatitis B surface antigen and human immunodeficiency virus among pregnant women in Anambra State, Nigeria. Shir E- Med J. 2004;5:20-22
Shepard CW, Simard EP, Finelli L, Fiore AE and Bell BP. Hepattis B virus infection: epidemiology and vaccination. Epidemiol Rev. 2006;28:112-125
Omeje KN, Ibekwe RC, Ojukwu JO, Una AF and Ibe BC: Risk factors for hepatitis B surface antigenaemia among secondary school students in Abakaliki, South Eastern Nigeria. Niger J Paediatr 2017; 44 (1): 14 –21
Adoga MP, Gyar SD, Pechulano S, et al. Hepatitis B virus infection in apparently healthy urban Nigerians: data from pre-vaccination tests. J Infect Dev Ctries 2010;4(6):397-400
Okonko IO, Okerentugba PO and Akinpelu AO. Prevalence of HBsAg among attendees of ARFH centre in Ibadan, southwestern Nigeria. Am-Euras J Sci Res. 2012;7(3):100-105
Jombo GT, Egah DZ and Banwat EB. Hepatitis B virus infection in a rural settlement of Northern Nigeria. Nig J Med 2005;14(4):425-428
Otegbayo JA, Fasola FA and Abja A. Prevalence of hepatitis B surface and e antigens, risk factors for viral acquisition and serum transaminase among blood donors in Ibadan, Nigeria. Trop Gastroenterol 2003;24(4):196-197
Bwogi J, Braka F, Makumbi I, et al. Hepatitis B infection is highly endemic in Uganda: findings from a national serosurvey. African Health Sci 2009;9(2):98-108
Balogun TM, Durojaiye IO, Sagoe A and Emmanuel S. Seroepidemiology of Hepatitis B Surface Antigenaemia in HIV Positive Patients. West African J Medicine 2010;29(3):169-173
Uneke CJ, Ogbu O, Inyama PU, et al. Prevalence of Hepatitis B Surface Antigen among Blood Donors and Human Immunodeficiency Virus Infected Patients in Jos, Nigeria. Mem Inst Oswaldo Cruz, Rio de Janeiro 2005;100(1):12-16
Sule WF, Okonko IO, Yunusa IP, Odu NN and Frank-Peterside N. Detection of Hepatitis B surface antigen (HBsAg) and risk factors of transmission among patients attending Universal Hospital, Ankpa, Kogi state, Nigeria. Nature and Sci 2011;9(10):37-44
Mehmet D, Meliksah E, Serif Y, et al. Prevalence of Hepatitis B infection in the south-eastern region of Turkey: Comparison of risk factors for HBV infection in rural and urban areas. J Infectious Dis 2005;58:15-19
Japhet MO, Adesina OA, Donbraye E and Adewumi MO. Hepatitis B Core IgM Antibody (Anti-HbcIgM) among Hepatitis B Surface Antigen (HBsAg) Negative Blood Donors in Nigeria. Virol J. 2011;10:8:513. doi: 10.1186/1743-422X-8-513.
Oluyinka, OO, Tong HV, Bui Tien S, et al. Occult Hepatitis B Virus Infection in Nigerian Blood Donors and Hepatitis B Virus Transmission Risks. PLoS One. 2015;10(7), e0131912.DOI: 10.1371
Lavanchy D. Hepatitis B virus epidemiology, disease burden, treatment, and current and emerging prevention and control measures. Journal of Viral Hepatitis 2004; 11(2): 97–107
Aba HO and Aminu M. Seroprevalence of Hepatitis B Virus Serological Markers among Pregnant Nigerian Women. Ann. Afr. Med. 2016; 15(1): 20–27.
Ojo OS, Thursz M, Thomas HC, et al. Hepatitis B virus markers, hepatitis D virus antigen and hepatitis C virus antibodies in Nigerian patients with chronic liver disease. East Afr Med J 1995;72:719-721.
Ola SO, Otegbayo JA, Yakubu A, et al. Pitfalls in diagnosis of hepatitis B virus infection among adults Nigerians. Niger J Clin Pract 2009;12:350-354.
Forbi JC, Iperepolu OH, Zungwe T and Agwale SM. Prevalence of Hepatitis B e Antigen in Chronic HBV Carriers in North-Central Nigeria. J Health Popul. Nutr. 2012; 30(4): 377–382.
Yang H-I, Lu S-N, Liaw Y-F, et al.; Taiwan Community-Based Cancer Screening Project Group. Hepatitis B e antigen and the risk of hepatocellular carcinoma. N Engl J Med 2002;347:168-174
You S-L, Yang H-I and Chen C-J. Sero-positivity of hepatitis B e antigen and hepatocellular carcinoma. Ann Med 2004;36:215-224.
Milich D and Jake LT. Exploring the Biologic Basis of Hepatitis B e Antigen in Hepatitis B Virus Infection. Hepatology 2003;38:1075–1086. DOI:10.1053/ jhep.2003.50453.
Oyero OG and Omoruyi EC. High Prevalence of Isolated Hepatitis B Core Antibody among Adults in Oyo State, Nigeria: The Need for Review of Diagnostic and Vaccination Guidelines. IJTDH 2016;13(1):1-10
Jeremiah ZA, Idris H, Ajayi BB, et al. Isolated antiHBc IgM antibody among blood donors in the semi-arid region of Nigeria. Human Antibodies 2011;20(3-4):77-82
Conjeevaram HS and Lok AS. Occult hepatitis B virus infection: a hidden menace? Hepatology 2001;34:204-206
Levy M and Koren G. Hepatitis B vaccine in pregnancy: maternal and fetal safety. Am J. Perinatol. 1991;8(3):227–232