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Objectives: Chronic hepatitis B (CHB) infection, both in human immunodeficiency virus (HIV) coinfection and hepatitis B virus (HBV)-mono-infection, is associated with a risk of progression to chronic liver disease. In Nigeria, there is a paucity of data on transient elastography (TE) in HIV/HBV and HBVmono-infected patients. This study aimed at assessing liver fibrosis using TE in relation to liver function biomarkers and HBV deoxyribonucleic acid (DNA) among HIV/HBV and HBV-mono-infected patients on long-term antiviral therapy. Material and Methods: This was a cross-sectional study among HBV-HIV and HBV-mono-infected adult's patients receiving a tenofovir-containing antiretroviral and mono-tenofovir =12 months at three selected tertiary hospitals in Jos Metropolis from February 2018 to May 2019, after obtaining ethical approval from the Institutional Review Boards and informed consents. The patients' HBV DNA, platelet count, hematological, and biochemical parameters were assessed, and liver stiffness was measured by TE in kilopascals (kPa), and valid TE measurements were interpreted as: normal (F0-1 0-4), minimal fibrosis (F2 5-7.4), moderate (F3 7.5.9.4), and severe fibrosis and cirrhosis (F4 =9.5). Results: A total of 101 (50 HIV/HBV and 51 HBV-mono-infected) were enrolled during the study period, comprising 42.6% males and 57.4% females. The median age interquartile range among HIV/HBV coinfected was 40.5 years (36.0-45.3) and HBV-mono-infected was 41.0 years (35.0-49.0). The median platelet count was low in the HBV-mono-infected group 195 × 109/L (168-257), P = 0.034. The overall prevalence of severe liver fibrosis (=9.5 kPa) was 13/101 (13.0%), and among HIV/HBV-coinfected and HBV-mono-infected patients, the prevalence was 4/50 (8.0%) and 9/51 (17.6%), respectively. The plasma HBV DNA was <20 copies/mL in 38/50 (76.0%) HIV/HBV coinfected individuals and in 30/51 (58.8%) of HBV-mono-infected patients. In addition, 10/50 (20.0%) HIV/HBV coinfected and 19/50 (37.3%) HBV-mono-infected patients had plasma HBV DNA levels of 20-20,000 copies/mL. In the case of HIV/HBV coinfection, the prevalence of severe fibrosis (=9.5) was 4/50 (8.0%), while in HBV-mono-infected patients, the prevalence was was 9/51 (17.6%). The overall prevalence of thrombocytopenia was observed in 4/101 cases (3.9%): 1/50 (2.0%) in HIV/HBV coinfected individuals and 3/51 (5.9%) in HBV-mono-infected patients. Conclusion: Severe liver fibrosis as observed among HIV/HBV-coinfected and HBV-mono-infected patients in this study affirmed the necessity of routine HBV screening in clinics and it highlights the immense potentials of tenofovir therapy in the treatment of CHB patients. [ABSTRACT FROM AUTHOR]

Background: Hepatitis B Virus Hepatitis B Virus (HBV) infection is a global public health problem. It is highly endemic in Nigeria and it is estimated that about 9-12% of the total population of Nigeria are chronic carriers of hepatitis B surface antigen. Epidemiological data on (HBV)infection among pregnant women in Nigeria are very scarce, especially in rural areas. The purpose of this study was to determine the prevalence and potential perinatal transmission among rural pregnant women in Abakaliki Nigeria. Methods: A cross-sectional study was conducted among pregnant women accessing antenatal care at the Federal Teaching Hospital, Abakaliki. We consecutively recruited 300 pregnant women attending antenatal consultations. A pretested questionnaire was used to collect socio-demographic data and factors associated with HBV infection. The presence of hepatitis B surface antigen (HBsAg), hepatitis B e antigen (HBeAg), and human immunodeficiency virus (HIV) were determined using commercial test strips. A chi-square test was used for the analysis. Results: The mean age was 31.8 (SD6.2) years. All women were married and (23.4%) were farmers while (47.0%) had secondary education. Sixteen women (5.3%) were HBsAg-positive, of whom (6.3%) were positive for HBsAg. The prevalence of HIV infection was (0.3%). Overall, (6.3%) women were co-infected with HIV and HBV. Independent correlates of HBV infection included a history of Jaundice (p = 0.046) history of sexually transmitted infections (p=0.005) and concurrent infection by HIV (p < 0.0001). Conclusion: The prevalence of HBV infection among pregnant women in Abakaliki was intermediate. The relatively high rate of women positive to both HBsAg and HBeAg suggests that perinatal transmission of HBV might be the prevailing mode of HBV transmission in this area. [ABSTRACT FROM AUTHOR]

Background: Previous studies in Nigeria have reported the presence of hepatitis B virus (HBV) genotype E and the availability of immune escape mutants. There is a paucity of data on chronic patients on long-term antiviral therapy for HBV infection. Objective: This study assessed HBV genotypes and drug resistance variants among patients with chronic HBV infection receiving tenofovir in Jos, Nigeria. Methods: This cross-sectional study consecutively enrolled 101 patients (51 with HIV/HBV co-infection and 50 with HBV infection only) on antiviral therapy from February 2018 to May 2019 at four hospitals in Jos, Nigeria. DNA quantification of HBV was performed on all samples; 30 samples with detectable viral load were selected for genotyping using Sanger sequencing by targeting the full-length sequences of reverse transcriptase gene of the HBV genome. Phylogenetic analysis was performed with reference sequences from GenBank. Escape mutant and drug resistance analysis were performed using HBV drug resistance interpretation and Geno2pheno. Results: Only 30 (29.7%) of the 101 study participants had detectable HBV DNA. Of these, six (20.0%) isolates were successfully amplified and sequenced. The identified genotype was E, including escape mutations L127R (16.7%) and G145A (16.7%). Conclusion: This study revealed exclusive dominance of genotype E in Nigeria. The S gene mutations G145A and L271R are known to be associated with modified antigenicity and impaired serologic assays, which may cause false negatives in the detection of anti-HBV surface antigen. The presence of mutants that are associated with vaccine immune escape may also have diagnostic and vaccine immune response implications. [ABSTRACT FROM AUTHOR]

Objectives: The study aimed at detecting the prevailing hepatitis B virus (HBV) genotypes and the presence of clinically relevant mutations in the precore/core gene of the HBV DNA, among patients with chronic infection in South-eastern, Nigeria. Methods: A total of 72 participants with chronic HBV infection were enrolled into the study. Plasma samples from those with detectable HBV DNA were subjected to nested Polymerase Chain Reaction amplification using the precore/core specific primers. This resulted to the successful amplification and sequencing of the HBV precore/ core region DNA from 16 participants. Mutation analysis on the precore/core region detected the presence of certain HBV precore/core gene mutations. Genotyping was carried out by phylogenetic analysis. Results: The precore region mutation at nucleotide position 1896, which is a G to A change resulting to a nonsense mutation, was detected in 6.25% of the participants. Other HBV precore region mutations that were detected include: G1899A, T1846A, G1862C, G1888A, T1821C, C1826T, A1827C, A1850T, C1858T, precore start codon Kozak sequence mutations and some novel core region mutations such as G/A1951T and G1957A. Genotyping revealed the existence of HBV genotype/subgenotype A1 (87.5%) and D (12.5%) among the participants. There was no significant difference in the occurrence of specific precore/core mutations among the HBV/hepatitis C virus dually infected and HBV mono-infected participants. Conclusion: The data suggest the likelihood of a more severe outcome of hepatitis caused by HBV in South-eastern Nigeria due to the occurrence of a variety of precore/core mutation, which resulted to HBeAg-negative chronic HBV infection among the participants. [ABSTRACT FROM AUTHOR]

Introduction: Hepatitis D virus (HDV) is a satellite virus of hepatitis B virus (HBV). An estimated 5% of HBV infected individuals worldwide have HDV infection. There is paucity of studies in Nigeria on the burden of HDV infection. This study aimed at determining the prevalence rate of HDV antibodies among individuals with chronic hepatitis B (CHB) infection and comparing the liver function test (LFT) and disease severity among the anti-HDV positive (anti-HDV+) and anti-HDV negative (anti-HDV-) individuals. Methodology: A cross-sectional study of 180 CHB infected individuals who were clinically evaluated and tested for HDV antibodies using the Enzyme-linked Immunoassay method. Their LFT profile and Child-Turcotte-Pugh (CTP) were also assessed. Data were analyzed using the SPSS version 17. Results: Their mean age was 35.2 ± 10.4 years. There were 150 (83.3%) and 30 (16.7%) individuals with uncomplicated and complicated CHB infection respectively. Thirty-four (18.9%) of the participants were anti-HDV+. The mean serum ALT, AST, albumin and INR of the anti- HDV+ subjects were 16.5 ± 13.8 IU/L, 26.3 ± 32.6 IU/L, 38.9 ± 7.6 g/L, and 1.2 ± 0.2 respectively. The mean values for the same parameters of the anti-HDV- subjects were 10.8 ± 9.5 IU/L, 13.4 ± 11.2 IU/L, 41.4 ± 6.0 g/L and 1.1 ± 0.2 respectively (p < 0.05). The mean CTP scores in the anti-HDV+ and anti-HDV- subjects were 6.1 ± 2.1 and 5.5 ± 1.2 respectively (p= 0.03). Conclusions: Anti-HDV sero-prevalence rate was 18.9% and anti-HDV+ CHB patients had worse LFT results compared to those who were anti-HDV--. [ABSTRACT FROM AUTHOR]

Background: HIV co-infection with hepatitis B (HBV) and/or hepatitis C virus (HCV) is common, largely due to shared routes of transmission, but paucity of data exists for long term treatment outcomes of HIV infected patients, and those co-infected with HBV and HCV despite the high burden in Nigeria. The aim of study was to describe the longterm treatment outcomes in HIV infected Nigerians and to assess the effect of HBV and HCV co-infections on longterm response to antiretroviral therapy (ART). Methodology: This was a retrospective study of HIV infected adults (> 18 years old) consecutively initiating ART between July 2004 and December 2007, who were followed up for 7 years (2011 and 2014). HBV and HCV infections were diagnosed by detection of serum hepatitis B surface antigen (HBsAg) and HCV antibody (HCVAb) respectively. HIV viral load and CD4 count were monitored 3-monthly after initiating ART, and treatment outcomes based on these were compared between patients with HIV mono-infection, HIV/HBV, HIV/HCV and HIV/HBV/HCV co-infections. Clinical and laboratory data of the patients were abstracted from the medical databases, FileMaker Pro, v 10, entered into Microsoft Excel, and analyzed using SPSS version 20.0. Results: A total of 2,800 adults were evaluated (median age of 35.5 years; 64.2% female), of whom 197 (7.0%) were co-infected with HBV, 53 (1.9%) with HCV, and 15 (0.5%) with HBV and HCV. During the 7-year period, 369 (13.2%) patients were lost to follow up. Immune reconstitution, measured by CD4 recovery, was lower in both HBV and HCV co-infections compared to HIV mono-infection, but this was not statistically significant (p>0.05). Median baseline HIV viral load was 4.63 log copies/ml for all groups, which decreased to undetectable level at a median time of 6 months and remained so for the study duration. Conclusion: This study revealed a higher virologic failure among HIV/HCV co-infected group compared to other groups. No immunological difference in ART treatment outcomes between HIV mono-infected and those co-infected with HBV and HCV after 7-year follow-up. Gradual rise in CD4 was found to be an immunological evidence of the body's recovery from HIV, buttressed by the drop in viral load over the 7-year period. [ABSTRACT FROM AUTHOR]

Hepatitis B infection is a major public health issue with a high mortality rate. It is caused by hepatitis B virus (HBV), a small incomplete hepadnavirus with several open reading frames (ORF). High mutation rates of the HBV ORFs due to the virus' replicating strategy are associated with the development and emergence of mutant strains, which may result in occult infections that are undetectable by conventional diagnostic assays. In this study, we first investigated the presence and prevalence of hepatitis B surface antigen (HBsAg) and HBV DNA among 204 patients visiting the specialist hospital in Osogbo, Nigeria, by using the Acumen diagnostic test strip kit and PCR amplification of the surface antigen gene. Then, we compared the positive results detected by both assays. The mean age of the participants was 30.5 years. Twenty-two (10.78%) cases were positive in the HBsAg test, and 69 (33.82%) cases were positive for HBV DNA. Fifty-four false-negatives (26.47%) and four false-positives (1.96%) were detected by HBsAg. The rapid diagnostic test kit is less sensitivity and has lower detection capability compared with the PCR-based assay, which indicates the presence of mutant HBV strain(s). The results of this work demonstrate that HBsAg is endemic in Nigeria and that HBV DNA is highly prevalent among the population. Our findings highlight the need for immediate action to prevent the further spread of infection. [ABSTRACT FROM AUTHOR]

BACKGROUND: Hepatitis B virus infection is a global public health problem. The virus has infected more than one-third of the global population. It has been estimated that 360 million chronic carriers are living around the world with a high risk for developing cirrhosis, hepatic carcinoma and hepatic failure. OBJECTIVE: The aim of this study was to determine the prevalence of some hepatitis B markers among pregnant women attending antenatal clinic in Sokoto Specialist Hospital, Nigeria. METHODS: The hepatitis testing was carried out using the Skytec-Rapid Diagnostic HBV-5 rapid kit (Skytec-Rapid Diagnostic, USA). The kit is based on lateral flow chromatographic immunoassay for the qualitative detection of HBsAg, HBsAb, HBeAg, HBeAb, and HBcAb in human serum or plasma. Panel format can conveniently test for five targets at once and utilizes all markers to help distinguish between acute and chronic infections. RESULTS: Out of 117 pregnant women tested, 15 were positive for HBsAg (12.8%), 6 positive for HBsAb (5.1%), 1 for HBeAg (0.9%), 14 tested positive for HBeAb (12.0%), and 14 tested for HBcAb (12.0%). The prevalence of HBsAg, HBsAb, HBeAg, HBcAb and HBcAb was compared based on ethnicity. HBsAb was significantly higher among the Hausa ethnic group (p = 0.001). The prevalence of HBsAb, HBeAg, HBcAb and HBcAb was not affected by ethnicity (p > 0.05). The prevalence of HBsAg, HBsAb, HBeAg, HBcAb and HBcAb was compared based on age. Infection by the hepatitis B virus markers was higher among young adult and middle age groups. The difference was however not statistically significant (p > 0.05). The prevalence of HBsAg, HBsAb, HBeAg, HBcAb and HBcAb was compared based on the educational status, previous history of blood transfusion, jaundice, employment status and previous history of still births among the pregnant subjects. There were no statistically significant differences in the prevalence of Hepatitis B virus markers (p > 0.05). CONCLUSION: The study observed a high prevalence of various hepatitis B viral markers among pregnant women attending antenatal care in Specialist Hospital Sokoto. There is need for routine screening of all pregnant women and infants born to hepatitis B positive mothers. Government and non-governmental organizations should intensify efforts to enlighten the general population on the public health importance of the disease and the importance of hepatitis screening. There is also need for the development of a treatment protocol for the management of pregnant women positive for hepatitis B to prevent mother to child transmission. There is an urgent need for the implementation of evidenced-based best practice of providing universal vaccination against hepatitis B for all hepatitis B negative women of child bearing age in particular and all Nigerians in general. [ABSTRACT FROM AUTHOR]

Background: The global burden of hepatitis (inflammation of the liver) infection is still a major public health challenge and burden in the 21st century, especially in endemic regions due to unavailability of early diagnostic techniques and treatments. The presence of chronic or fulminant hepatitis B virus (HBV) and/or hepatitis C virus (HCV) infection(s) had caused extensive and irreversible liver damage in different population groups from different parts of the world today, including Nigeria. Aim: The aim of this study was to determine the seropositivity prevalence rates of HBV and HCV infections among pregnant women attending antenatal clinic at the State Specialist Hospital Akure, Ondo State, Nigeria. Materials and Methods: A review of hematological data was done for a period of 1 year which spanned from May 2015 to April 2016. During this period, pregnant women were recruited prospectively from the antenatal clinic and screened for HBV and HCV infections. The evaluation includes risk factor assessment based on age group and determination of rapid serology for hepatitis B surface antigen (HBsAg) and hepatitis C antibodies. Results: The results from our study revealed that out of the 1758 pregnant women recruited and screened, 1.47% and 0.00% within the age range of 25–29 years were positive to HBsAg and HCV, respectively. Conclusion: In conclusion, the 4.2% overall prevalence rate obtained for HBsAg-positive women fell within the reference range for the general population in Nigeria (2.4%–18.4%). The observed overall prevalence value for HBsAg positive women also fell within the 2%–7% reference range for South-Western region geographical prevalence category for Nigeria which showed an intermediate endemic rate within the age range of 25–39 years. The prevalence outcome of this study is an alert threshold attributed to endemic sexual activity of this age range (25–39 years) and prevailing epidemic factors for HBV transmission among reproductive age group. [ABSTRACT FROM AUTHOR]