Abstract

BackgroundHepatitis 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.MethodsThis 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.ResultsOut 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 < 0.05). No significant associations were observed with regard to HDV seroprevalence and available demographic factors. Phylogenetic analyses demonstrated a predominance of HDV genotype 1 and HBV genotype E among the HDV-RNA/HBsAg positive patients.ConclusionsIn conclusion, our study showed a high prevalence of HDV infection in HBsAg carriers and the predominance of HDV genotype 1 infection in Nigerian HBV endemic region. The findings contribute to a better understanding of the relevance of HDV/HBV co-infection and circulating genotypes.

Highlights

  • Hepatitis B virus (HBV) and hepatitis D virus (HDV) infections are major public health problems in sub-Saharan Africa

  • Sample characteristics and HDV prevalence Of the 188 hepatitis B surface antigens (HBsAg) positive serum samples from outpatients recruited at four tertiary hospitals in Southwestern Nigeria, 82 (43.6 %) were from females and 106 (56.4 %) were from males

  • Due to the low volume of serum samples available, only 103 of the 188 HBsAg positive samples could be examined for prevalence of anti-HDV antibodies; HDV genome detection was possible from all 188 samples

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Summary

Introduction

Hepatitis B virus (HBV) and hepatitis D virus (HDV) infections are major public health problems in sub-Saharan Africa. We assessed the HDV seroprevalence and determined the HDV and HBV genotypes distribution among HBsAg positive individuals in Southwestern Nigeria. 15 to 20 million individuals are infected with HDV [2,3,4]. In Africa, of the estimated 65 million chronic HBV carriers, about one fourth of HBsAg-positive individuals show dual-infection with HDV [4]. HDV is a spherical hybrid particle of ~36 nm in diameter, composed of an outer coat containing hepatitis B surface antigens (HBsAg) and host lipids. The inner nucleocapsid consists of small and large hepatitis D delta antigens (sHDAg and LHDAg) and a single-stranded, circular RNA molecule of ~1.7 kb [6, 7]. SHDAg is required for HDV genome synthesis while LHDAg inhibits HDV-RNA synthesis and is essential for HDV particle The unique open reading frame of the HDV genome encodes the delta antigens. sHDAg is required for HDV genome synthesis while LHDAg inhibits HDV-RNA synthesis and is essential for HDV particle

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