Seroprevalence, co-infection and risk of transmission of Hepatitis B and D virus among hospital attendees in two South-western states in Nigeria.

Infection with both Hepatitis B (HBV) and D (HDV) virus causes more severe liver damage than HBV alone. Superinfections among chronic HBV infected cohorts often lead to HDV persistence with rapid progression to cirrhosis, necessitating continuous surveillance to determine their prevalence and relative contribution to liver pathology. A cross-sectional study among hospital outpatients in Ekiti and Osunstates was conducted using random sampling technique. Blood samples were collected from 410 participants and tested for HBV serological markers. All samples positive for HBsAg samples were tested for Hepatitis D virus antigen (HDAg), serum anti-HDV IgM, and serum anti-HDV IgG using enzyme-linked immunosorbent assay kits. The prevalence of HBV infection among the 410 samples was 12.4% (CI 9.5-15.9). Past HBV exposure was detected in 120 (29.2%), while 147(35.8%) were susceptible to HBV infection. Among the HBsAg positive individuals, 9.8% were hepatitis D antigen (HDAg) positive, while 3.9% and 1.9% were positive for IgG anti-HDV and IgM anti-HDV, respectively. Risk factors associated with HBV infections in this study were multiple sexual partners and sharing of sharp objects. Our investigation has verified the endemicity of HBV in Nigeria and revealed that HBV- HDV co-infection is highly prevalent in south-west Nigeria.

Assessment of PMTCT Success Rates Based on Antiretroviral Interventions and Feeding Options: A Prospective Cohort Study.

BACKGROUND: The success of any prevention of mother-to-child transmission (PMTCT) program is assessed by the proportion of HIV-exposed infants that sero-convert at the end of all risk exposures. Although adopting the best feeding option for HIV-exposed infants is one of the factors that impact PMTCT outcomes, there is limited data on the assessment of PMTCT success rates based on antiretroviral interventions and feeding options. This study assesses the success rate of PMTCT service based on antiretroviral interventions and feeding options. METHODS: Eighty-five HIV-infected mothers previously in care were enrolled in a prospective cohort study. Folders and structured questionnaires were used to extract data on mother-infant pair and the first CD4, count of infected mothers on enrolment at PMTCT clinic. Dry blood spot samples were obtained from exposed infants for early infant diagnosis. Results were analyzed using the SPSS software. RESULTS: The mean age of enrolled mothers was 31.3 ± 4.4 years, and an average CD4+ T-lymphocyte count of 368.6 ± 216.2 cells/µl. Seven (8.2%) of the HIV-exposed infants were positive for HIV-1 based on early infant diagnosis results. Overall PMTCT success rate (PMTCTSR) was 91.8%. HIV-1 prevalence of 5.0%, 0% and 21.1% was found among infants of patients who opted for breastfeeding, replacement feeding, and mixed feeding respectively thus yielding PMTCT success rates of 95%, 100% and 78.9%. Pediatric antiretroviral interventions success rates in HIV-exposed infants was 95.8%, 80.0% and 66.7% based on age groups ≤ 6 months, > 6 ≤ 12 months, and > 12 ≤ 18 months respectively. CONCLUSION AND GLOBAL HEALTH IMPLICATIONS: Quality PMTCT service is vital for successful prevention of mother-to-child transmission of HIV. Implementation of more dynamic approaches such as adherence to option B+ guidelines in PMTCT service in our settings can further reduce mother-to-child transmission of HIV and improve outcomes.