Anti-Hepatitis B Surface Antibody (Anti-HBsAb) in a Representative Population of Ozuoba in Rivers State, Nigeria
DOI:
https://doi.org/10.12970/2309-0529.2018.06.02Keywords:
Anti-HBsAb, Antibody, ELISA, HBsAb, HBV, Prevalence, Nigeria.Abstract
Background: Hepatitis B infection is a foremost worldwide health issue of public health significance and chief origin of chronic hepatitis, cirrhosis and hepatocellular carcinoma (HCC). There are vaccines available for hepatitis B infection which can be used for prevention before infection. In an effort to prevent and control HBV, the Nigeria Government in 2004 made HBV vaccine as part of national immunization programme. This definitely is an essential procedure to minimize the occurrence of HBV in many countries. Thus, our study was designed to investigate the seroprevalence of hepatitis B surface antibody (HBsAb) in a representative population of Ozuoba in Rivers State, Nigeria following the incorporation of HBV vaccine into NPI schedule. Methods: Ninety (90) blood samples were obtained from a male and female population of Ozuoba community in Rivers State, Nigeria. Questionnaires were distributed to obtain demographic profile of participants. ELISA (DIA.PRO Diagnostic Bioprobes, Milano-Italy) was employed for the qualitative and quantitative evaluation of HBsAb in sera and plasma of representative population of Ozuoba in Rivers State, Nigeria. The serological evaluation and result interpretation were carried out as stipulated by the kit’s manufacturers. We engaged Fisher's exact test and Chi-square test to estimate variances amid groups at p < 0.05 significance. Results: Of the 90 participants evaluated, nine tested seropositive for HBsAb giving a general prevalence of 10.0% and a seronegativity of 90.0%. The sex-related prevalence was males (7.1%) and females (12.5%). Sex and age had no effect in hepatitis B surface antibody (p-value> 0.05). The age-specific prevalence was 7.7% for age group 13-19 years, 10.2% for 20-35 years of age and 10.7% for 36 years and above. Conclusion: This study revealed that the presence of HBsAb was low (10.0%). Our outcomes indicted that seropositivity and seronegativity of HBsAb have no significant relationship with age and sex. It further showed that 90.0% were HBsAb seronegative and hence, more susceptible to HBV infection. Vaccination programme must be strengthened further to grasp those continuing at highest risk.References
[1] Hou J, Liu Z, Gu F. Epidemiology and Prevention of Hepatitis B Virus Infection. Int J Med Sci 2005; 2(1): 50-57. https://doi.org/10.7150/ijms.2.50
[2] Lohoues-Kouacou MJ, Assi C, Simen-Kapeu A, Badje AD, Kone S, Ouattara A, Soro D, Camara BM. Prevalence of HBV Sero-markers in two Different Socioeconomic Groups of Schoolchildren from Abidjan, Côte-d’Ivoire. Journal of Gastroenterology and Hepatology Research 2013; 2(9): 798- 802.
[3] Biswas RS, Karim MN, Bhattacharjee B. Hepatitis B virus infection and vaccination status among health care workers of a tertiary care hospital in Bangladesh. Journal of the Scientific Society 2015; 42(3): 176-179. https://doi.org/10.4103/0974-5009.165561
[4] Ikobah J, Okpara H, Elemi I, Ogarepe Y, Udoh E, Ekanem E. The prevalence of hepatitis B virus infection in Nigerian children prior to vaccine introduction into the National Programme on Immunization schedule. The Pan African Medical Journal 2016; 23: 128. https://doi.org/10.11604/pamj.2016.23.128.8756
[5] Odusanya OO. Hepatitis B Virus Vaccine: The Nigerian Story. Journal Of The Obafemi Awolowo University Medical Student's Association (IFEMED Journal) 2008; 14 (1): 4-5. https://doi.org/10.4314/ifemed.v14i1.41725
[6] Musa B, Bussell S, Borodo MM, Samaila AA, Femi OL. Prevalence of hepatitis B virus infection in Nigeria 2000- 2013: A systematic review and meta-analysis. Niger J Clin Pract 2015; 18: 163-72. https://doi.org/10.4103/1119-3077.151035
[7] World Health Organization. Hepatitis B: World Health Organization Fact Sheet 204. World Health Organization; [2000]. Available at http://www.who.int/mediacentre/ factsheets/fs204/en/. Accessed April 12 2016
[8] Lok AS. Chronic hepatitis B. N Engl J Med 2002; 346: 1682- 1683. https://doi.org/10.1056/NEJM200205303462202
[9] Lok AS, McMahon BJ. Chronic hepatitis B. Hepatology 2007; 45(2): 507-539. https://doi.org/10.1002/hep.21513
[10] Mahoney FJ. Update on Diagnosis, Management, and Prevention of Hepatitis B Virus Infection. Clin Microbial Rev 1999; 12: 351-366.
[11] Lee WM. Hepatitis B infection. New England Journal of Medicine 1997; 337: 1733-1745. https://doi.org/10.1056/NEJM199712113372406
[12] Teo EK, Lok ASF. Epidemiology, transmission, and prevention of hepatitis B virus infection (In Kaplan SL, Esteban R, Mitty J, eds). Wolters Kluwer Ltd., United States & Canada. Available at: http://www.uptodate.com/ contents/epidemiology-transmission-and-prevention-ofhepatitis-b-virus-infection. Accessed November 26 2016.
[13] Ott JJ, Stevens GA, Groeger J, Wiersma ST. Global epidemiology of hepatitis B virus infection: new estimates of age-specific HBsAg seroprevalence and endemicity. Vaccine 2012; 30: 2212. https://doi.org/10.1016/j.vaccine.2011.12.116
[14] Schweitzer A, Horn J, Mikolajczyk RT, et al. Estimations of worldwide prevalence of chronic hepatitis B virus infection: a systematic review of data published between 1965 and 2013. Lancet 2015; 386: 1546. https://doi.org/10.1016/S0140-6736(15)61412-X
[15] Zhang Q, Qi W, Wang X, et al. Epidemiology of Hepatitis B and Hepatitis C Infections and Benefits of Programs for Hepatitis Prevention in Northeastern China: A CrossSectional Study. Clin Infect Dis 2016; 62: 305. https://doi.org/10.1093/cid/civ859
[16] Stevens CE, Beasley RP, Tsui J, Lee WC. Vertical transmission of hepatitis B antigen in Taiwan. N Engl J Med 1975; 292: 771. https://doi.org/10.1056/NEJM197504102921503
[17] Tassopoulos NC, Papaevangelou GJ, Sjogren MH, et al. Natural history of acute hepatitis B surface antigen-positive hepatitis in Greek adults. Gastroenterology 1987; 92: 1844. https://doi.org/10.1016/0016-5085(87)90614-7
[18] Wasley A, Grytdal S, Gallagher K. Centers for Disease Control and Prevention (CDC). Surveillance for acute viral hepatitis--United States 2006. MMWR Surveill Summ 2008; 57: 1.
[19] World Health Organization. Recommendations on Viral hepatitis 2010. Available from: http://www.apps.who.int/ gb/ebwha/pdf_files/EB126/B126_R16-en.pdf. [Last accessed on 2014 May 31].
[20] World Health Organization. Global policy report on the prevention and control of viral hepatitis 2012. Available from: http://www.apps.who.int/iris/bitstream/10665/85397/1/ 9789241564632_eng.pdf. [Last accessed on 2014 May 31].
[21] World Health Organization. Global Immunization coverage 2016. WHO Fact sheet Reviewed March 2016. Available at http://www.who.int/mediacentre/factsheets/ fs378/en/#. Accessed April 29 2016.
[22] Rainey JJ, Watkins M, Ryman TK, Sandhu P, Bo A, Banerjee K. Reasons related to non-vaccination and under-vaccination of children in low and middle income countries: Findings from a systematic review of the published literature, 1999-2009. Vaccine 2011; 29: 8215-21. https://doi.org/10.1016/j.vaccine.2011.08.096
[23] Cutts FT, Izurieta HS, Rhoda DA. Measuring coverage in MNCH: Design, implementation, and interpretation challenges associated with tracking vaccination coverage using household surveys. PLoS Med 2013; 10: e1001404.
[24] GAVI Alliance. Country Tailored Approach for Nigeria 2014- 2018; 2014. Available from: http://www.apps.who.int/ immunization_monitoring/globalsummary/estimates?c=NGA. [Last accessed on 2014 May 27].
[25] World Health Organization. Introduction of Hepatitis B vaccine into childhood immunization services 2001. Accessed 2nd February 2014. Available; http://www.who.int/ vaccines-documents.
[26] World Health Organization. Hepatitis B Fact sheet N0 204 2009. Accessed 2nd February 2014. Available; http://www.who.int/csr/disease/hepatitis. Updated July 2015. Accessed May 02 2016.
[27] Chang MH, Chen TH, Hsu HM, Wu TC, Kong MS, Liang DC, Ni YH, Chen CJ, Chen DS; Taiwan Childhood HCC Study Group. Prevention of hepatocellular carcinoma by universal vaccination against hepatitis B virus: the effect and problems. Clin Cancer Res 2005; 11: 7953-7957. https://doi.org/10.1158/1078-0432.CCR-05-1095
[28] Ni YH, Chen DS. Hepatitis B vaccination in children: the Taiwan experience. Pathol Biol (Paris) 2010; 58: 296-300. https://doi.org/10.1016/j.patbio.2009.11.002
[29] Macfarlane SB. Conducting a Descriptive Survey: 2. Choosing a Sampling Strategy. Trop Doct 1997; 27(1): 14-21. https://doi.org/10.1177/004947559702700108
[30] Niang L, Winn T, Rusli BN. Practical issues in calculating the sample size for prevalence. Studies Archives of Orofacial Sciences 2006; 1: 9-14.
[31] Awando JA, Ongus JR, Ouma C, Mwau M. Seroprevalence of Anti-Dengue Virus 2 Serocomplex Antibodies in OutPatients with Fever visiting Selected Hospitals in Rural Parts of Western Kenya in 2010-2011: A Cross Sectional Study. The Pan African Medical Journal 2013; 16: 73. https://doi.org/10.11604/pamj.2013.16.73.2891
[32] Torresi J, Earnest-Silveira L, Deliyannis G, Edgtton K, Zhuang H, Locarnini SA, Fyfe J, Sozzi T, Jackson DC. Reduced antigenicity of the hepatitis B virus HBsAg protein arising as a consequence of sequence changes in the overlapping polymerase gene that are selected by lamivudine therapy. Virology 2002; 293(2): 305-313. https://doi.org/10.1006/viro.2001.1246
[33] Weber B. Genetic variability of the S gene of hepatitis B virus: clinical and diagnostic impact. J Clin Virol 2005; 32(2): 102-112. https://doi.org/10.1016/j.jcv.2004.10.008
[34] Colson P, Borentain P, Motte A, Henry M, Moal V, BottaFridlund D, Tamalet C, Gérolami R. Clinical and virological significance of the co-existence of HBsAg and anti-HBs antibodies in hepatitis B chronic carriers. Journal of Virology 2007; 367(1): 30-40. https://doi.org/10.1016/j.virol.2007.05.012
[35] Margeridon S, Lachaux A, Trepo C, Zoulim F, Kay A. A quasi-monoclonal anti-HBs response can lead to immune escape of ‘wild-type’ hepatitis B virus. J Gen Virol 2005; 86(Pt 6): 1687-1693. https://doi.org/10.1099/vir.0.80810-0
[36] Lada O, Benhamou Y, Poynard T, Thibault V. Coexistence of hepatitis B surface antigen (HBs Ag) and anti-HBs antibodies in chronic hepatitis B virus carriers: influence of “a” determinant variants. J Virol 2006; 80(6): 2968-2975. https://doi.org/10.1128/JVI.80.6.2968-2975.2006
[37] Shapiro CN. Epidemiology of hepatitis B. Pediatr Infect Dis J. 1993; 12(5): 433-437. https://doi.org/10.1097/00006454-199305000-00036
[38] Bolarinwa RA, Aneke JC, Olowookere SA, Salawu L. Seroprevalence of transfusion transmissible viral markers in sickle cell disease patients and healthy controls in Ile-Ife, South-Western Nigeria: A case-control study. J Appl Hematol 2015; 6: 162-7. https://doi.org/10.4103/1658-5127.171985
[39] Chernesky MA, Browne RA, Rondi P. Hepatitis B virus antibody prevalence in anaesthetists. Canadian Anaesthetists’ Society Journal 1984; 31(3): 239-245. https://doi.org/10.1007/BF03007882
[40] Acharya SK, Madan K, Dattagupta S, Panda SK. Viral hepatitis in India. Natl Med J India 2006; 19: 203-217.
[41] Biswas D, Borkakoty BJ, Mahanta J, Jampa L, Deouri LC. Hyperendemic Foci of Hepatitis B Infection in Arunachal Pradesh, India. J Assoc Physicians India 2007; 55: 701-704.
[42] Lewis TL, Alter HJ, Chalmers TC, Holland PV, Purcell RH, Alling DW, Young D, Frenkel LD, Lee SL, Lamson ME. A Comparison of the Frequency of Hepatitis-B Antigen and Antibody in Hospital and Nonhospital Personnel. N Engl J Med 1973; 289: 647-651. https://doi.org/10.1056/NEJM197309272891301
[43] Janzen J, Tripatzis I, Wagner U, Schlieter M, Müller-Dethard E, Wolters E. Epidemiology of Hepatitis B Surface Antigen (HBsAg) and Antibody to HBsAg in Hospital Personnel. The Journal of Infectious Diseases 1978; 137(3): 261-265. https://doi.org/10.1093/infdis/137.3.261
[44] Salpini R, Colagrossi L, Bellocchi MC, Surdo M, Becker C, Alteri C, Colagrossi L, Bellocchi MC, Surdo M, Becker C, Alteri C, Aragri M, Ricciardi A, Armenia D, Pollicita M, Di Santo F, Carioti L, Louzoun Y, Mastroianni CM, Lichtner M, Paoloni M, Esposito M, D'Amore C, Marrone A, Marignani M, Sarrecchia C, Sarmati L, Andreoni M, Angelico M, Verheyen J, Perno CF, Svicher V. Hepatitis B surface antigen genetic elements critical for immune escape correlate with hepatitis B virus reactivation upon immunosuppression. Hepatology 2015; 61(3): 823-833. https://doi.org/10.1002/hep.27604
[45] Singhal V, Bora D, Singh S. Prevalence of hepatitis b virus infection in healthcare workers of a tertiary care center in India andtheir vaccination status. JVaccinesVaccin 2011; 2: 2. https://doi.org/10.4172/2157-7560.1000118
[46] Papaevangelou G, Trichopoulos D, Kremastinou T, Papoutsakis G. Prevalence of hepatitis B antigen and antibody in prostitutes. Br Med J 1974; 2(5913): 256-8. https://doi.org/10.1136/bmj.2.5913.256
[47] Payne RW, Barr A, Wallace J. Hepatitis B antigen (HBAg) and its antibody (HBAb) in hospital patients. J Clin Pathol 1974; 27(2): 125-9. https://doi.org/10.1136/jcp.27.2.125
[48] Leers WD. Prevalence of hepatitis B surface antibodies in ethnic groups of a Canadian hospital staff population. Infect Immun 1977; 17(2): 257-262.
[49] Lauer JL, VanDrunen NA, Washburn JW, Balfour HH Jr. Transmission of hepatitis B virus in clinical laboratory areas. J Infect Dis 1979; 140: 513-6. https://doi.org/10.1093/infdis/140.4.513
[50] Werner BG, Grady GF. Accidental hepatitis-B-surfaceantigen-positive inoculations. Use of e antigen to estimate infectivity. Annals of Internal Medicine 1982; 97: 367-369. https://doi.org/10.7326/0003-4819-97-3-367
[51] Romieu I, Sow I, Lu S, Larogue G, Prince-David M, RometLemonne JL. Prevalence of hepatitis B markers among hospital workers in Senegal. J Med Virol 1989; 27: 282-7. https://doi.org/10.1002/jmv.1890270405
[52] Zarina F, Humayun A, Najam UB, Falimi A, Dil AS, Syed SZ, Kazi BM. Prevalence of Hepatitis B Virus in Dental Clinics in Rawalpindi/Islamabad. Journal of Pakistan Medical Association 1998; 259. Available at http://www.jpma.org.pk/ full_ article_text.php?article_id=3837. Accessed April 11 2016.
[53] Zhang H, Li Q, Sun J, Wang C, Gu Q, Feng X, Du B, Wang W, Shi X, Zhang S, Li W, Jiang Y, Feng J, He S, Niu J. Seroprevalence and Risk Factors for Hepatitis B Infection in an Adult Population in Northeast China. Int J Med Sci 2011; 8(4): 321-331. https://doi.org/10.7150/ijms.8.321
[54] Liang X, Bi S, Yang W, Wang L, Cui G, Cui F, Zhang Y, Liu J, Gong X, Chen Y, Wang F, Zheng H, Wang F, Guo J, Jia Z, Ma J, Wang H, Luo H, Li L, Jin S, Hadler SC, Wang Y. Epidemiological serosurvey of Hepatitis B in China— Declining HBV prevalence due to Hepatitis B vaccination. Vaccine 2013; 31(Suppl 9): J21-J28. https://doi.org/10.1016/j.vaccine.2013.08.012
[55] Aghakhani A, Banifazl M, Izadi N, McFarland W, Sofian M, Khadem-Sadegh A, Pournasiri Z, Foroughi M, Eslamifar A, Ramezani A. Persistence of antibody to hepatitis B surface antigen among vaccinated children in a low hepatitis B virus endemic area. World J Pediatrics 2011; 7(4): 358-360. https://doi.org/10.1007/s12519-011-0286-4
[56] Guo Y, Xu J, Li J, Dong P, Ye Y, Feng X, Zhang Y, Guo W. An epidemiological serosurvey of hepatitis B virus shows evidence of declining prevalence due to hepatitis B vaccination in central China. International Journal of Infectious Diseases 2015; 40: 75-80. https://doi.org/10.1016/j.ijid.2015.10.002
