Abstract
BackgroundHepatitis B virus (HBV) causes significant morbidity and mortality globally primarily due to its ability to cause hepatitis, liver cirrhosis and hepatocellular carcinoma. The Kenya National Blood Transfusion Services screens for Hepatitis B antibodies using the chemiluminescent microparticle immunoassay method. This test does not inform on the genotypic characteristics of the virus or the actual presence of the virus in blood. This study therefore sought to determine the serologic and genotypic profiles of HBV circulating among the voluntary blood donors in Nairobi.MethodsBlood samples were collected in plain and EDTA vacutainers and tested for the Hepatitis B surface antigen (HBsAg). HBV DNA was then extracted from plasma, its overlapping P/S gene amplified and sequenced. The resulting sequences were used to analyze for the circulating genotypes and mutations within the P and S genes. Bivariate statistical analysis was used to determine the association between demographic factors and HBV infection.ResultsA seroprevalence of 2.3% (n = 7) was reported. The age group 19–28 years was significantly associated with HBV infection. Nine samples were positive for HBV DNA; these included 2 HBsAg positive samples and 7 HBsAg negative samples. Genotype A, sub genotype A1 was found to be exclusively prevalent while a number of mutations were reported in the “a” determinant segment of the major hydrophilic region of the S gene associated with antibody escape. RT mutations including mutation rt181T in the P gene conferring resistance against Lamivudine and other ʟ-nucleoside drugs were detected.ConclusionThere is a high prevalence of occult HBV infections among these blood donors and therefore the testing platform currently in use requires revision.
Highlights
Hepatitis B virus (HBV) causes significant morbidity and mortality globally primarily due to its ability to cause hepatitis, liver cirrhosis and hepatocellular carcinoma
Study population There was a total of 300 voluntary blood donors who were recruited in the study majority of whom were male; 59.3% (n = 178) while 0.7% (n = 2) were not willing to disclose their gender
Serology Based on the chemiluminescent microparticle immunoassay (CMIA) results, 97.6% (n = 293) samples tested Hepatitis B surface antigen (HBsAg) negative while 2.3% (n = 7) tested positive
Summary
Hepatitis B virus (HBV) causes significant morbidity and mortality globally primarily due to its ability to cause hepatitis, liver cirrhosis and hepatocellular carcinoma. The Kenya National Blood Transfusion Services screens for Hepatitis B antibodies using the chemiluminescent microparticle immunoassay method. This test does not inform on the genotypic characteristics of the virus or the actual presence of the virus in blood. About 2 billion people are infected with Hepatitis B virus (HBV), with about 360 million at risk of developing complications due to the infection. Of the 2 billion infected individuals, more than 65 million residing in Africa are chronically infected and are at risk of HBV related complications. These complications include liver cirrhosis and hepatocellular carcinoma. The studied groups in Kenya so far have included drug users, pregnant women, children attending post natal clinics, people living with HIV/AIDS, blood donors and patients in specific regions around the country
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