Hepatitis B virus infections in apparently healthy urban Nigerians: data from pre-vaccination tests

Abstract

Background: In spite of the availability of an effective vaccine since 1982 against hepatitis B, infection with hepatitis B virus (HBV), which is 50 to 100 times more infectious than HIV, still persists in most parts of the world with Nigeria being described as an endemic zone. We therefore set out to establish the prevalence of this infection and evaluate its relationship with age and gender in urban Nigerians. Methodology: During pre-vaccination tests, blood samples were collected by finger-prick and venepuncture from 1,891 subjects aged ≤ 60 years, between 2008 and 2009 after having obtained informed consent and ethical clearance. Smart Check HBsAg (Globalemed, Cape Town, South Africa) and ShantestTM-HBsAg Elisa (Shantha Biotechnics Ltd, Hyderabad, India) were used for initial and confirmatory tests respectively. Results: Of the 1,891 participants, 957 (50.6 %) were males and 934 (49.4%) were females. Overall 114 (6.0%) were positive, of whom 71 (7.4%) were males and 43 (4.6%) females. Those aged 21-30 years had the highest infection rate, and males were more likely to be infected with the virus than females (P > 0.05). Conclusions: Such a high prevalence of a vaccine-preventable infection questions the effectiveness of the Nigerian vaccination strategies. The Nigerian government hepatitis B vaccination programme, which hitherto is limited to the National Childhood Immunisation Programme, should include the adult population.

Immunovirological and Biochemical Changes in Nigerian Patients with Hepatitis B Coinfection on Antiretroviral Therapy

“…The preponderance of the female gender had been suggested to be due to the fact that women may be more sensitive to changes in their health and probably socioculturally conditioned to seek health care more than men [6]. The significantly higher coinfection among men compared with women in spite of a predominant female gender affected with HIV is likely a reflection of HBV prevalence among the general population which has been noted to be higher amongst men [15]. The lower prevalence of coinfection among the better educated individuals generally could be due to the level of awareness that may be associated with education and therefore behaviours and practices that may reduce HBV transmission [16].…”

Prevalence and Burden of Human Immunodeficiency Virus and Hepatitis B Virus Co-infection in Nigeria: A Systematic Review and Meta-Analysis

“…All of the 33 studies were conducted in urban areas . Two [25,29] of the studies were prospective, three [40,41,51] were retrospective, one [22] had retrospective and prospective arms and the remaining studies were cross sectional design. The total number of HIV-infected participants was 53899 in the 33 studies analyzed.…”

“…Heterogeneity chi-squared was 1610.84 (d.f.=33) p=0.000, I-squared (variation in ES attributable to heterogeneity) was 98.0% and estimate of between-study variance Tau-squared was 0.0043. Ajayiet al [22] Adeshina et al [23] Adewole et al [24] Adoga et al [25] Eke et al [26] Ajayi et al [27] Ashir et al [28] Balogun et al [29] Buseri [30] Diwe et al [31] Ejele et al [32] Nwolisa et al [33] Anigilaje et al [34] Idoko et al [35] Ladep et al [36] Lar et al [37] Mustapha et al [38] Nwokedi et al [39] Okocha et al [40] Oronsaye et al [41] Otegbayo [42] Tremeau-Bravard et al [43] Uneke et al [44] AkyalaIshaku et al [45] Bello et al [46] Denue et al [47] Ekanem et al [48] Hamza et al [49] Opara-Morrison et al [50] Omonkhelin et al [51] Frank -Petersideet al [52] Sadoh et al [53] Okeke et al [54] Odunukwe et al The REM estimate of prevalence among HIV-infected patients from 33 studies was 15% (95% CI 13-17%) (Figure 3). There was a publication bias in Egger's, and Begg's testing (Begg's test, p=0.003; Egger's test, p=0.000).…”

“…On sensitivity analysis, i.e. the weight of individual studies on the pooled summary effect showed that the prevalence estimate was dominated by Ajayi et al [25], Ladep et al [54] and Odunukwe [52] studies ( Figure 5).…”

Epidemiology, virology, transmission, clinical manifestation and vaccine for hepatitis virus B: a review

“…3 The prevalence of the disease varies between 2 in advanced countries while the prevalence is about 8% in developing countries where infection is highly endemic with age, sex and socioeconomic status as the important risk factors for the diseases. 4 The predominant mode of transmission of HBV correlates with degree of its endemicity. The disease has major impact on health and economy of many countries and as well the severity of the infection is mostly variable and often unpredictable.…”