Hepatitis B Core IgM antibody (anti-HBcIgM) among hepatitis B Surface antigen (HBsAg) negative blood donors in Nigeria

<p>Abstract</p> <p>Background</p> <p>Transfusion associated Hepatitis B virus (TAHBV) continues to be a major problem despite mandatory screening for Hepatitis B surface Antigen (HBsAg). Presence of HBsAg is the common method for detecting hepatitis B infection. Unfortunately, this marker is not detected during the window period of the infection. Nigeria being a developing country cannot afford DNA testing of all collected units of blood which serve as the only possibility of achieving zero risk of transfusion associated HBV. Five different serological makers of hepatitis B virus (HBV) infection were therefore assessed to evaluate the reliability of using HBsAg marker alone in diagnosis of HBV infection among blood donors and to detect the serological evidence of the infection at the window period. This will preclude the possibility of transmitting hepatitis B through transfusion of Hepatitis B surface antigen (HBsAg) negative blood in Nigeria.</p> <p>Methods</p> <p>Between July and August 2009, 92 blood donors were enrolled for the study. The prevalence of 5 different markers of Hepatitis B virus infection was detected using Enzyme Linked Immunosorbent Assay (ELISA). Demographic factors were assessed during the study.</p> <p>Results</p> <p>HBsAg and its antibody (anti-HBs) was detected in 18 (19.6%) and 14(15.2%) of the 92 blood donors respectively. Anti-HBc IgM was found in 12(13.0%) of the 92 blood donors while Hepatitis B envelope antigen (HBeAg) and its antibody (anti-HBe) were detected in 4(8.9%) and 12(26.7%) respectively from 45 donors sampled. HBeAg is a marker of high infectivity and appears after HBsAg. At least one serological marker was detected in 30(32.6%) of the blood donors. Five (5.4%) of the 92 donors had anti-HBc IgM as the only serological evidence of hepatitis B virus infection.</p> <p>Conclusions</p> <p>The result of this study shows that five donors have anti-HBcIgM as the only serological evidence of HBV infection. Inclusion of anti-HBcIgM in routine screening of blood donors in Nigeria should be encouraged. This is the first study to assess anti-HBcIgM in the country.</p

High Prevalence of Anti-HCV Antibodies Among Pregnant Women in Southwestern Nigeria

Hepatitis C virus (HCV) is the most common cause of cirrhosis, hepatocellular carcinoma and liver transplantation. While universal screening for other blood-borne viruses (BBVs) such as HIV and HBV among pregnant women is recommended in Nigeria, no such recommendation exist for HCV in the country. Despite recently developed direct-acting antiviral agents (DAAs) to cure HCV at high rates and at very high cost, the absence of an HCV vaccine or approved therapy during pregnancy makes prevention of vertical transmission impossible at the moment. Using a commercially available enzyme linked immunoassay technique, prevalence of antibodies to hepatitis C virus (anti-HCV) was determined among pregnant women attending antenatal clinics in Southwestern Nigeria. Of the 273 serum samples obtained from the pregnant women 9.5% was positive for anti-HCV antibody. There were differences in anti-HCV prevalence by age and locality. Results of the study confirm endemicity of HCV among pregnant women in the country, consequently, we advocate free screening, among other essential measures for HCV intervention in Nigeria. Keywords: HCV, Hepatitis, Pregnant women, Seroprevalence, ELISA, Nigeri

HBV INFECTION AMONG HIV-INFECTED COHORT AND HIV-NEGATIVE HOSPITAL ATTENDEES IN SOUTH WESTERN NIGERIA

Background: Prevalence, association and probable mode of acquisition of HBV and HIV dual infections have not been fully explored. Thus, HBV intervention plan and services are sometimes exclusively targeted towards HIV-infected population. We investigated HBV infection among HIV-infected cohort in comparison with HIV-negative hospital attendees to ascertain dual infectivity pattern; thereby encouraging appropriate allotment of intervention services. Materials and Methods: A total of 349 (M=141; F=208; Mean=33.98 years; Range= 0.33-80 years) plasma specimens from two virus diagnostic laboratories in south-western Nigeria were analysed. These include 182 HIV-positive and 167 HIV-negative specimens from ART and GDV laboratories respectively. The specimens were initially screened for detectable HIV antigen/antibody, and subsequently HBsAg by ELISA technique. Results: Overall, HBsAg was detected in 20.92% (95% CI: 16.65-25.19%) of the patients. Also, 24.82% (95% CI: 17.69-31.95%) and 18.27% (95% CI: 13.02-23.52%) HBsAg positivity was recorded for males and females respectively. CHI square analysis showed no association (P=0.14) between gender and prevalence of HBsAg. Similarly, comparison of prevalence of HBsAg by age groups shows no significant difference (P=0.24). Overall, no significant difference (P=0.59) was observed in the prevalence of HBsAg among the HIV-infected cohort and HIV-negative hospital attendees. Conclusions: Results of the study confirm endemicity and comparable rates of HBV infection independent of HIV-status

IMMUNITY TO POLIOVIRUS SEROTYPES IN CHILDREN POPULATION OF SELECTED COMMUNITIES IN SOUTH-WEST, NIGERIA

Background: Poliovirus outbreaks are still reported in Nigeria despite renewed efforts to improve vaccine coverage, thus suggesting the existence of susceptible hosts. Also, there is anecdotal evidence of variation in vaccine coverage by region and specifically between urban and rural communities. Consequently, this study assessed neutralizing antibodies to poliovirus serotypes among children in selected urban and rural communities in south western Nigeria. Methodology: Two hundred and forty-four {(M=119, F=125); Urban: 142 (M=63, F=79); Rural: 102 (M=56, F=46)} children of consenting parent/guardian aged one week to 15 years were enrolled for the study. About 2-3ml of blood was collected from each child by venepuncture into a labelled sterile container free of anticoagulants. Subsequently, questionnaire was administered to the parent/guardian of each child to retrieve relevant information. Recovered sera were analysed for detectable neutralizing antibodies to poliovirus serotypes by the standard method of constant virus, varying serum dilutions. Results: Overall, 64.3% (n=157) of the children had detectable neutralizing antibodies to the three poliovirus serotypes. Also, 84.8% (n=207), 91.0% (n=222) and 75.0% (n=183) of the children had detectable antibodies to poliovirus serotypes 1, 2 and 3 respectively. Eighty seven (35.7%) of the children had no detectable neutralizing antibody to at least one of the three poliovirus serotypes, while 9 (3.7%) children had no detectable neutralizing antibody to the three poliovirus serotypes. Geometric mean titre (GMT) of neutralizing antibodies to the three poliovirus serotypes varied significantly (p=0.0005). Conclusion: Disparity in immunity to poliovirus infection and existence of children with low or zero neutralizing antibody levels were confirmed

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Direct Detection and Identification of Enteroviruses from Faeces of Healthy Nigerian Children Using a Cell-Culture Independent RT-Seminested PCR Assay

Recently, a cell-culture independent protocol for detection of enteroviruses from clinical specimen was recommended by the WHO for surveillance alongside the previously established protocols. Here, we investigated whether this new protocol will show the same enterovirus diversity landscape as the established cell-culture dependent protocols. Faecal samples were collected from sixty apparently healthy children in Ibadan, Nigeria. Samples were resuspended in phosphate buffered saline, RNA was extracted, and the VP1 gene was amplified using WHO recommended RT-snPCR protocol. Amplicons were sequenced and sequences subjected to phylogenetic analysis. Fifteen (25%) of the 60 samples yielded the expected band size. Of the 15 amplicons sequenced, 12 were exploitable. The remaining 3 had electropherograms with multiple peaks and were unexploitable. Eleven of the 12 exploitable sequences were identified as Coxsackievirus A1 (CVA1), CVA3, CVA4, CVA8, CVA20, echovirus 32 (E32), enterovirus 71 (EV71), EVB80, and EVC99. Subsequently, the last exploitable sequence was identified as enterobacteriophage baseplate gene by nucleotide BLAST. The results of this study document the first description of molecular sequence data on CVA1, CVA8, and E32 strains present in Nigeria. The result further showed that species A enteroviruses were more commonly detected in the region when cell-culture bias is bypassed

Molecular epidemiology of hepatitis D virus circulating in Southwestern Nigeria

Background: Hepatitis B virus (HBV) and hepatitis D virus (HDV) infections are major public health problems in sub-Saharan Africa. Whereas it is known that HBV infection is endemic in Nigeria, there is only little data about HDV prevalence available. Here, we assessed the HDV seroprevalence and determined the HDV and HBV genotypes distribution among HBsAg positive individuals in Southwestern Nigeria. Methods: This cross-sectional study involved 188 serum samples from HBsAg positive outpatients recruited at four tertiary hospitals in Southwestern Nigeria. Anti-HDV antibodies were detected by ELISA while HDV-RNA was detected by RT-PCR. Sequencing followed by phylogenetic analyses and HBV genotype-specific PCR were used to characterize HDV and HBV genotypes, respectively. Results: Out of 188 HBsAg positive serum samples, 17 (9 %) showed detectable HDV-RNA. Anti-HDV antibodies test was possible from 103 samples and were observed in 4.9 % (5/103) patients. There was no significant difference in HDV prevalence between four main cities across the country. 64.7 % of HDV-RNA positive samples were from males and 35.3 % from females (P

Occult Hepatitis B Virus Infection among HIV Positive Patients in Nigeria

HIV has been known to interfere with the natural history of hepatitis B virus (HBV) infection. In this study we investigate the prevalence of occult hepatitis B virus infection (OBI) among HIV-infected individuals in Nigeria. Overall, 1200 archived HIV positive samples were screened for detectable HBsAg using rapid technique, in Ikole Ekiti Specialist Hospital. The HBsAg negative samples were tested for HBsAg, anti-HBc, and anti-HCV by ELISA. Polymerase chain reaction was used for HBV DNA amplification and CD4 counts were analyzed by cytometry. Nine hundred and eighty of the HIV samples were HBsAg negative. HBV DNA was detected in 21/188 (11.2%) of patients without detectable HBsAg. CD4 count for the patients ranged from 2 to 2,140 cells/μL of blood (mean = 490 cells/μL of blood). HCV coinfection was detected only in 3/188 (1.6%) of the HIV-infected patients (P>0.05). Twenty-eight (29.2%) of the 96 HIV samples screened were positive for anti-HBc. Averagely the HBV viral load was <50 copies/mL in the OBI samples examined by quantitative PCR. The prevalence of OBI was significantly high among HIV-infected patients. These findings highlight the significance of nucleic acid testing in HBV diagnosis in HIV patients