Evaluation of Hepatitis-B and Its Markers Among Some Attendees of Two Health Facilities In Port Harcourt, Rivers State, Nigeria

A cross-sectional investigation of hepatitis-B status among attendees of Modern Primary Health Centre, Eneka and Rivers State University Teaching Hospital, Port Harcourt was evaluated. Seven hundred (700) subjects of different ages of both sexes were included in the study after ethical approval was obtained from the Rivers State Ministry of Health, Port Harcourt. Consent forms were issued to get subjects’ consent before questionnaire administration to obtain their demographic data. The uninfected subjects were used as control. About 4mls of blood was taken from each subject by vein-puncture; 2mls each was dispensed into EDTA and plain bottles for analysis. The samples were used to assay for hepatitis-B surface antigen (HBsAg), hepatitis–B virus (HBV) markers (HBsAb, HBeAg, HBeAb, HBcAb) using standard techniques. The overall prevalence of HBV was 5.1% in Port Harcourt. The males had higher prevalence of 7.9% HBV than the females 3.4% HBV, although there was no statistically significant difference (P ≥0.05). The HBV was highest among subjects of age group 24-29 years (8.29%) and 30-35 years (9.2%) accordingly. The HBV markers results show that while HBsAg occurred among all the subjects that were positive for HBV, HBeAb was completely absent.

Serum HBV RNA correlated with intrahepatic cccDNA more strongly than other HBV markers during peg-interferon treatment

Background Serum hepatitis B virus RNA (HBV RNA) has been reported to be a surrogate marker of intrahepatic cccDNA during nucleos(t)ide analogs therapy. However, in HBeAg-positive patients treated with peg-interferon (peg-IFN), whether HBV RNA is superior to other HBV markers in reflecting cccDNA profile is still unclear. Methods Serum HBV RNA, HBcrAg, HBV DNA, and HBsAg were longitudinally assessed among 30 HBeAg-positive patients during 48-week peg-IFN treatment. Besides, intrahepatic cccDNA was detected at baseline and week 48 respectively. Then, the individual correlations between HBV RNA, HBcrAg, HBV DNA, HBsAg, and cccDNA were statistically analyzed. Results HBV RNA levels decreased more rapidly in patients with HBeAg seroconversion than those without HBeAg seroconversion. Among all patients, cccDNA correlated better with HBV RNA than with HBcrAg, HBV DNA, and HBsAg at baseline. After 48 weeks peg-IFN treatment, cccDNA still correlated more strongly with HBV RNA than other HBV markers. Further analysis indicated that in patients with HBeAg seroconversion cccDNA strongly correlated with HBV RNA and HBcrAg, whereas not correlate with HBV DNA and HBsAg. While in patients without HBeAg seroconversion, cccDNA highly correlated with HBV RNA and HBV DNA, moderately correlated with HBcrAg, and not correlated with HBsAg. Conclusion Compared to HBcrAg, HBV DNA, and HBsAg, serum HBV RNA correlated more strongly with intrahepatic cccDNA levels before and after 48-week peg-IFN treatment. The level of serum HBV RNA may be a superior surrogate marker in reflecting the intrahepatic cccDNA profile in HBeAg-positive patients during peg-IFN treatment. Trial registration ClinicalTrials, NCT03546530. Registered 1 January 2015. https://clinicaltrials.gov/ct2/results?cond=&term=NCT03546530.

Cryptic HBV Replicative Activity Is Frequently Revealed in Anti-HBc-Positive/HBsAg-Negative Patients with HIV Infection by Highly Sensitive Molecular Assays, and Can Be Predicted by Integrating Classical and Novel Serological HBV Markers

The anti-HBc-positive/HBsAg-negative status is frequent in HIV-infection and correlates with poor survival. Here, by highly-sensitive assays, we evaluate cryptic HBV replication and factors correlated with its detection in 81 anti-HBc-positive/HBsAg-negative HIV-infected patients. Patients were treated for >12 months with HBV-active modern combined antiretroviral-therapy (cART) and had serum HBV-DNA < 20 IU/mL by commercial Real-Time PCR. Serum HBV-DNA was quantified by droplet digital PCR, serum HBV-RNA by an Abbott research assay, and anti-HBc titer (proposed to infer intrahepatic cccDNA) by Lumipulse/Fujirebio. Cryptic serum HBV-DNA was detected in 29.6% of patients (median (IQR): 4(1–15) IU/mL) and serum HBV-RNA in 3.7% of patients despite HBsAg-negativity and HBV-active cART. Notably, cryptic serum HBV-DNA correlated with an advanced CDC-stage (p = 0.01) and a lower anti-HBs titer (p = 0.05), while serum HBV-RNA correlated with lower nadir CD4+ cell-count (p = 0.01). By analyzing serological HBV-markers, the combination of anti-HBs < 50 mIU/mL (indicating lower immune response) plus anti-HBc > 15COI (reflecting higher HBV replicative activity) was predictive of cryptic serum HBV-DNA (OR: 4.7(1.1–21.7), p = 0.046, PPV = 62.5%, and NPV = 72%). In conclusion, cryptic HBV-replication (not detected by classical assays) characterizes a conspicuous set of anti-HBc-positive HIV-infected patients despite HBsAg-negativity and HBV-active combined antiretroviral therapy (cART). The integration of classical and novel markers may help identify patients with cryptic HBV-replication, thus optimizing the monitoring of anti-HBc-positive/HBsAg-negative HIV-infected patients.

Serum HBV RNA Correlated with Intrahepatic cccDNA More Strongly than other HBV Markers During Peg-Interferon Treatment

Background: Serum hepatitis B virus RNA (HBV RNA) has been reported to be a surrogate marker of intrahepatic cccDNA during nucleos(t)ide analogs therapy. However, whether HBV RNA is superior to other HBV markers reflecting cccDNA profile in HBeAg-positive patients during peg-interferon (peg-IFN) treatment was still unclear.Methods: Serum HBV RNA, HBcrAg, HBV DNA, and HBsAg were longitudinally assessed among 30 HBeAg-positive patients during 48-week peg-IFN treatment. The intrahepatic cccDNA was detected at baseline and week 48, respectively. The individual correlations between HBV RNA, HBcrAg, HBV DNA, HBsAg, and cccDNA were then statistically analyzed.Results: HBV RNA levels in patients with HBeAg seroconversion decreased more rapidly compared with those without HBeAg seroconversion. Among all patients, cccDNA correlated better with HBV RNA than with HBcrAg, HBV DNA, and HBsAg at baseline. After 48 weeks of treatment, cccDNA still correlated more strongly with HBV RNA than other HBV markers. For subsequent analysis, cccDNA positively correlated with HBV RNA and HBcrAg whereas did not correlate with HBV DNA and HBsAg in patients with HBeAg seroconversion. However, cccDNA highly correlated with HBV RNA and HBV DNA, moderately correlated with HBcrAg, while no correlation was observed between cccDNA and HBsAg in patients without HBeAg seroconversion.Conclusion: Serum HBV RNA correlated more strongly than HBcrAg, HBV DNA, and HBsAg with intrahepatic cccDNA levels before and after 48-week peg-IFN treatment. The level of serum HBV RNA may be a superior surrogate marker reflecting the intrahepatic cccDNA profile in HBeAg-positive patients during peg-IFN treatment.Trial registration: ClinicalTrials, NCT03546530. Registered 1 January 2015. https://clinicaltrials.gov/ct2/results?cond=&term=NCT03546530&cntry=&state=&city=&dist=

Predisposing Factors to HBV Among Pregnant Women Attending Some Hospitals in Suburbs of Kano, Nigeria

Hepatitis B virus (HBV) when transmitted vertically can be severe on neonates and life threatening. Among others, risk factors for HBV include unprotected sex, needle-stick injuries and blood transfusion. The study was conducted to determine the seroprevalence of HBV markers and associated risk factors among one hundred and sixty consenting pregnant women attending some hospitals in Kano, Nigeria. Using enzymelinked immunoassay, sera were screened for HBV sero-markers and structured questionnaires were administered to obtain sociodemographic data and possible predisposing factors to HBV infection. Of the five HBV markers known, participants tested positive for four, which include HBsAg, HBsAb, HBeAb and HBcAb. All were seronegative for HBeAg. Ninety three percent (93.1%) tested positive for at least one HBV marker and 6.9% were seronegative for all markers. Among those that tested positive for HBsAg, 54.5% (p=0.33) were housewives, 36.4% (p=0.53) had only primary school education, 72.7% (p=0.14) were middle-class, none had previous knowledge of HBV infection and its mode of transmission, 54.5% (p=0.14) regularly shares sharp objects, 45.5% (p=0.37) had ear or nose piercing, and 9.1% (p=0.01) regularly shares towel and underwear. A large percentage of the study group had history of the infection while only 1.3% of the subjects were vaccinated. Sociodemographic background of the participants, low vaccination coverage and certain risk factors like the sharing of unsterilized sharp objects seem to aid the moderately high prevalence of HBV in this study. The study also revealed that the risk of mother-to-child HBV transmission is low in the study area and that incomplete vaccination may not confer artificial immunity against HBV infection.