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.

Human immunonodeficiency virus, hepatitis B virus and hepatitis C virus: sero-prevalence, co-infection and risk factors among prison inmates in Nasarawa State, Nigeria

Background: Published data on HIV; HBV; and HCV in correctional facilities in Nigeria is scarce. We set out to establish the seroprevalence; co-infection; and risk factors for these infections for the first time among prison inmates in Nasarawa State; Nigeria. Methodology: In a cross-sectional study conducted between April and May; 2007; blood samples were collected from 300 male prisoners of a mean age of 29.2 years; in the state's four medium-security prisons (overall population: 587). Prior to the study; ethical clearance and informed consent were obtained and structured questionnaires were administered. Samples were analyzed for HIV; HBsAg; and HCV using anti-HIV 1 +2-EIA- avicenna; ShantestTM-HBsAg ELISA; and anti-HCV-EIA-avicenna; respectively. Specimens initially reactive for HIV were retested with vironostika microelisa. Data were analyzed using SPSS version 13.0. P values = 0.05 were considered significant. Results: Of the 300 subjects; 54 (18.0); 69 (23.0); and 37 (12.3) tested positive for HIV; HBV; and HCV; respectively. Co-infections were eight (2.7) for HIV/HBV and two (0.7) for HBV/HCV. Those aged 21-26 years were more likely to be infected with HIV and HBV; while those aged 33-38 years had the highest HCV infection. Associated risk factors included duration in prison; previous incarceration (for HIV; HBV and HCV); intra-prison anal sex; multiple sex partners (for HIV and HBV); ignorance of transmission modes; blood transfusion; and alcohol consumption (for HBV and HCV). No inmate injected drugs. Conclusions: The overall outcome represents the need for prison-focused intervention initiatives in Nigeria. Injected drug use is an unlikely major transmission mode among Nigerian inmates

Human immunodeficiency virus infection in Nigeria

Study of the increasing epidemic of human immunodeficiency virus (HIV) infection in Nigeria provides insight into the magnitude of its spread, and allows identification of particular population groups which must be the target for preventive measures and increased public awareness campaigns. We have reviewed records documenting the disease in Nigeria since the first case was reported in 1986. Prevalence surveys have allowed identification of the rate of increase in the infection in various regions of Nigeria, and among various population groups: blood donors, those attending ante-natal care clinics (ANC), those attending sexually transmitted diseases clinics (SDT), commercial sex workers (CSW), and patients with tuberculosis. We also reviewed the success of campaigns to increse awareness of AIDS in Nigeria. There were over 2 million cases of HIV infection in Nigeria in 1996, based on a national prevalence of 3.8 percent. The highest prevalence of infection was in the Middle Belt region of the country with 9.6 percent positivity of those tested in 1992, and 33.6 percent in 1994. Among blood donors, the percentage of those infected rose from 0 percent in 1987, to 4.4 percent in 1992, in one medical center; and in 1995, in ANC the prevalence ranged from 0.2 percent to 12.9 percent of mothers (median 5.0 percent). High rates of infection were recorded among CSW (71.3 percent in one region), those attending STD clinics (27.4 percent in one region), long-haul truck drivers and policemen. Patients with tuberculosis also had a high prevalence of infection. Public awareness and adequate surveillance data remain inadequate in view of the magnitude of the problem. Increased funding and judicious expenditures are essential to obtain and distribute accurate information in order to begin to resolve this epidemic.

Response to heterologous leishmanins in cutaneous leishmaniasis in Nigeria - discovery of a new focus

A pilot study was undertaken to preliminary illustrate the leishmanin skin test (LST) positivity to distinct antigen preparations (derived from promastigote of either Leishmania major or L. amazonensis, or pooled L. mexicana, L. amazonensis and L. guyanensis) in cutaneous leishmaniasis (CL) patients and healthy subjects living in two endemic foci in Nigeria. The study was designed to provide insights into whether cross-species leishmanin, such as that prepared from New World Leishmania could be useful to detect cases of Old World leishmanial infection and to compare the results with LST using L. major-derived leishmanin. The overall LST positivity in individuals from Keana tested with the cross-major-derived leishmanin was 28.7 per cent (27/94), while the positivity rate in the subjects from Kanana tested with the same leishmanin was 54.5 per cent (6/11). Lower positivity values were obtained when L. major (12.5 per cent; 11/88) or L. amazonensis (15.8 per cent; 9/57) was tested as antigen in grossly comparable populations. Moreover, the pooled leishmanin identified most of the subjects (13/14; 92.9 per cent) with active or healed CL, and the maximum reaction sizes were found among positive subjects in this group. No healthy controls (10 total) showed specific DTH response. The LST was useful for assessing the prevalence of subclinical infection and for measuring CL transmission over time. We report for the first time the occurrence of CL in Kanana village of Langtang South local government area of Plateau State.