Prevalence of hepatitis B e antigen in chronic HBV carriers in North-central Nigeria.

Hepatitis B virus (HBV) is an important clinical problem due to its worldwide distribution and potential of adverse sequelae, including hepatocellular carcinoma (HCC). We studied the prevalence of hepatitis B virus e antigen (HBeAg) among individuals determined to be HBV surface antigen-positive (HBsAg+) and analyzed the gender/age category associated with more active HBV infection. A total of 572 HBsAg+ individuals, as determined by a double antibody sandwich ELISA method, participated in the study. They were tested for HbeAg, using a lateral flow chromatographic immunoassay. One hundred and ten individuals were found to be HBeAg-positive giving an overall prevalence of 19.2%. Of these 110 individuals, 20 (18.2%) were females, and 90 (81.8%) were males. Thus, the prevalence of HBeAg appears to be higher in males than in females (p < 0.05). Our data also revealed that the prevalence of HBeAg was higher in patients between the age-group of 0-10 years and 11-20 years and appeared to decrease with increase in age. Taken together, our data show that approximately 1/5 of HBV-infected individuals are HBeAg+, suggesting that the virus is actively replicating and infecting liver-cells thereby ensuring an HBV-transmission pool within the Nigerian population. We suggest strengthening of the childhood HBV vaccination programmes, massive intervention activities, and treatment programmes, especially among young people to reverse the possible devastating effect of HBV infection. The success of these efforts will depend on our resolution to make the elimination of HBV infection a top priority on the public-health agenda as we start the second decade of this new century.

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

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 < or = 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.