SOURCE:

Faculty: Biosences
Department: Applied Microbiology And Brewing

CONTRIBUTORS:

Ezeji, C. N.
Oyeka, C. A.

ABSTRACT:

Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) are among the clinical conditions of public health importance with high morbidity and mortality worldwide, especially in developing countries. These three viral infections share common route of transmission that puts HIV positive individuals at risk of co-infection with HBV, HCV or both.It is therefore necessary to document the seroprevalence of HBV and HCV among HIV patients in Abuja.The sero-prevalence of HBV and HCV among HIV patients attending Asokoro, Maitama and Wuse district hospitals in Abuja was studied using the Rapid Test Device (RTD) strips, Enzyme Linked Immunosorbent Assay (ELISA) and Polymerase Chain Reaction (PCR). HIV patients were confirmed with the commercial HIV kits like; Alere HIV Determine, HIV Stat Pack and PCR method. Non-HIV volunteers in the same area served as control. Randox kits were used to estimate the serum bilirubin and liver enzyme profile. Enzyme Immunoassay was used for the quantitative determination of Alfa-fetoprotein. DNA and RNA were extracted with Zymo extraction kits, the genes purity quantified by Nanodrop 1000 and amplified by 9700 Applied BiosystemThermocycler. The amplicons were resolved by Agarose Gel Electrophoresis. Phylogenetic analysis and sequencing were done by Inqaba South Africa and data analysed statistically withGraphpad Prism version 7. A total of eight hundred (800) subjects were involved in the study using Stratified Random Sampling method; two hundred (200) each from the three district hospitals for the HIV patients and two hundred for the non HIV volunteers within Abuja Municipal. The overall prevalence of hepatitis in the three district hospitals were 8.5% for HBV and 5.7% for HCV with RTD while the prevalence with PCR increased to 31.25% for HBV and 18.25% for HCV respectively. The prevalence of hepatitis in Asokoro, Maitama and Wuse Hospitals with RTD was 10%, 4%, 9% and 8%, 6%, 5% respectively for HBV and HCV as against 40%, 20%, 45% and 26%, 20%, 19% for HBV and HCV when PCR method was used. For the non-HIV volunteers, the prevalence of hepatitis with RTD method was 11% and 4% respectively for HBV and HCV as against 20% and 8% respectively when PCR method was used. Hepatitis B markers determination using ELISA showed prevalence of 12.75%, 10.6%, 2%, 27.5% and 31% for Hepatitis B Surface Antigen (HBsAg), Hepatitis B Surface Antibody (HBsAb), Hepatitis B Envelop Antigen (HBeAg), Hepatitis B Envelop Antibody (HBeAb) and Hepatitis B Core Antibody (HbcAb) respectively. HIV HBV co-infected patients on ART had reduced HBV DNA of 78%, 57%, 16%, 40% for HBsAg, HBeAg, HBeAb, and HBcAb while non-HIV volunteers on herb also had reduced HBV DNA of 84%, 71%, 68% and 60% for HBsAg, HBeAg, HBeAb, and HBcAb. Young adults within the age group of 25-35 had the highest prevalence among the age range studied. The prevalence of HIV/HBV and HIV/HCV was 4% and 4.5% for the Hausas and 3.5% and 4.5% for the Igbos respectively which was higher than those of other tribes. The prevalence of HIV/HBV for Christians was 21.6% while 13.3% was the prevalence for the Muslims. The unemployed, petty traders and civil servant patients showed the highest prevalence of 18% and 8% respectively for HBV and HCV in the district hospitals. All the samples collected showed normal bilirubin result with average mean of ±0.6mg/dl for total bilirubin and ±0.20mg/dl for direct bilirubin. The mean ratio of Aspartate amino transferase (AST): Alanine Aminotransferase (ALT): Alkaline Phosphatase (ALP) for HBV positive patients was ±30iu/l: ±26iu/l: ±270iu/l respectively as against ±35iu/l: ±32iu/l: ±220iu/l for HCV positive patients. An estimate of Alfa-fetoprotein (AFP) level for 200 samples randomly selected across the hospitals and grouped in fifties (50 HIV mono infected, 50 HIV/HBV, 50 HIV/HCV and 50 HIV/HBV/HCV samples) showed increased AFP which was 2% for HIV mono-infected patients, 4% for HIV/HBV patients, 8% for HIV/HCV patients and 10% for HIV/HBV/HCV patients. Apart from Maitama hospital where the male had higher prevalence of 15% as against 5% of female for HCV, in other district hospitals the prevalence of HBV and HCV for female subjects were higher with 28%, 19% and 35% for female as against 12%, 6% and 10% for male HBV patients and 20%, 5%, 10% for female as against 12%, 15%, 9% for males HCV patients in Asokoro, Maitama and Wuse district hospitals respectively. The prevalence of HBV and HCV among the married HIV patients were 29%, 15%, 38% and 20%, 20% 19% respectively in Asokoro, Wuse and Maitama District hospitals which is higher than that obtained among the singles and divorced. The patients with secondary school educational background had highest prevalence of 22%, 15%, 21% and 15%, 10%, 8% respectively for HIV/HBV and HIV/HCV respectively than the primary school certificate holders in the three district hospitals. Patients resident in the out sketch of Abuja like Marraba and Nyanya showed the highest prevalence of HBV and HCV. Patients with behavioral lifestyle like multiple sex partners, unprotected sex and injectable drug users had the highest prevalence of HBV and HCV. The phylogenetic analysis HIV revealed HIV-1 isolates closely related to HIV-1 isolates from Cameroon and HIV-1 isolate from Nigeria. That of HBV revealed a closely relatedness of HBV isolate from Sudan and isolates from Sudan. The prevailing HBV genotype was HBV genotype E. The findings of this research confirm that HBV and HCV are major co-morbid infection and a threat to HIV patients. In conclusion, there is no much difference in the prevalence of HBV and HCV between HIV/HBV, HIV/HCV co-infected individuals and non HIV/HBV and HIV/HCV infected patients. The PCR is the best method of diagnosis. The liver function test revealed that HBV and HCV were not known to play a major role in causing jaundice at the onset of the infection. The government should improve in creating awareness and vaccinating the populace to reduce the prevalence of these infections.