Hepatitis B infection is highly prevalent among patients presenting with jaundice in Kenya

Abstract

BackgroundViral hepatitis is a major concern worldwide, with hepatitis A (HAV) and E (HEV) viruses showing sporadic outbreaks while hepatitis B (HBV) and C (HCV) viruses are associated with chronic hepatitis, cirrhosis and hepatocellular carcinoma. The present study determined the proportion, geographic distribution and molecular characterization of hepatitis viruses among patients seeking medical services at hospitals throughout Kenya.MethodsPatients presenting with jaundice at four selected hospitals were recruited (n = 389). Sera were tested for the presence of antibody to hepatitis viruses A through E, and HBV surface antigen (HBsAg). Nucleic acid from anti-HAV IgM antibody and HBsAg positive samples was extracted, amplified and sequenced.ResultsChronic HBV infection was the leading cause of morbidity among patients with symptoms of liver disease seeking medical help. Incident HCV, HEV and HDV infection were not detected among the patients in this study, while the proportion of acute HAV was low; HAV IgM positivity was observed in 6.3 % of patients and sequencing revealed that all cases belonged to genotype 1B. HCV seropositivity upon initial screening was 3.9 % but none were confirmed positive by a supplementary immunoblot assay. There was no serological evidence of HDV and acute HEV infection (anti-HEV IgM). HBsAg was found in 50.6 % of the patients and 2.3 % were positive for IgM antibody to the core protein, indicating probable acute infection. HBV genotype A was predominant (90.3 %) followed by D (9.7 %) among HBV DNA positive specimens. Full genome analysis showed HBV/D isolates having similarity to both D4 and D6 subgenotypes and D/E recombinant reference sequences. Two recombinant sequences demonstrated > 4 % nucleotide divergence from other previously known D/E recombinants.ConclusionsHBV is highly prevalent among patients seeking care for symptoms consistent with hepatitis, compared to the general population. Molecular characterization of HBV isolates indicated recombinant strains that may give rise to new circulating variants. There is a need to document the prevalence, clinical manifestation and distribution of the variants observed. HAV genotype 1B, prevalent in Africa, was observed; however, the absence of HCV, HDV and acute HEV in this study does not rule out their presence in Kenya.

Prevalence and Genetic Diversity of Hepatitis B and C Viruses Among Couples Attending Antenatal Care in a Rural Community in Rwanda

“…This is consistent with surveys conducted in Rwandan adults and blood donors, which found the majority of HBV infections in Rwanda were due to genotype A. 6,15 In the East African sub-region, HBV infections have been attributed to a genotypes A, B, C, D, E and H, 44,[49][50][51] but HBV genotypes A and D predominate. 11,52 In our study, HCV genotype 4 was the only one identified in confirmed HCV infections, which is consistent with a report on hepatitis care referral patients from Rwanda, in whom 96.7% HCV infections were due to HCV genotype 4.…”

Comprehending the Environmental and Household Determinants of Jaundice Prevalence in Western Nepal

“…Similarly, sporadic rain attributes in water contaminations through pathogens and abiotic mixtures and the water contamination is the major cause of Jaundice occurrence (Raguraman et al, 2017). Similarly, water contamination exacerbates the condition of Hepatitis-B infection (Ochwoto et al, 2016).…”

Identification and comparative analysis of hepatitis B virus genotype D/E recombinants in Africa

“…Hepatitis B virus genotype A is predominant in South/East Africa, D in North Africa, and E in West/Central Africa [12]. Genotype E hybrids are generally found in African countries with A/E recombinants in Cameroon, Ghana, and Guinea [35, 36] and D/E recombinants in Gabon, Ghana, Niger, Sudan, Kenya, and Ethiopia [33, 35, 37, 38]. There are two documented E hybrids reported from France (A/E) and Ireland (D/E); however, both involve patients originating from Africa [18, 39].…”