Details
Category: Volume 10 Issue 04 April 2022
Hits: 450

Title: Molecular Quantitation of Hepatitis B Virus DNA and Alanine Aminotransferase Levels as Marker of Disease Progression in Adult Patients with Chronic Hepatitis B Infection in Northwestern Nigeria

Authors: Abdallah Sanda, Akinfenwa Atanda, Oloyede Taiwo

 DOI: https://dx.doi.org/10.18535/jmscr/v10i4.22

Abstract

Background: The elevated levels of HBV DNA and alanine aminotransferase levels (ALT) remain major risk factors for progression of chronic HBV infection which is associated with serious, long-term complications.

Nucleic acid amplification tests (NAATs) measures viral genome in body fluids and are now widely used for estimating patient’s infectivity, assessment of prognosis, efficacy of antiviral treatment and identifying emergence of drug resistance.

Methods: The study was carried out on 136 participants. Blood specimens was obtained for quantitative PCR assay at the NCDC Molecular diagnosis laboratory using commercial reaction mix with an analytic sensitivity of 20-50 copies/ml of HBV DNA and serum was obtained for ALT assay. Data analyzed using Statistical Package for Social Sciences (SPSS) version 20 and results presented as tables

Results: A prevalence rate of 28.7% for Hepatitis B envelop antigen was established among subjects, while 71.3% were negative. The mean ALT level was 34.5IU/ml, 84.6% had normal ALT values, 1.5% were mildly elevated and up to 14% were markedly elevated. No strong association was found between HBeAg status and raised ALT levels.

The mean HBV DNA quantity was 37,094,093 copies/ml. About 85.3% had detectable levels of HBV DNA while 4.7% had levels below the lower limit of detection.

Conclusion: HBV DNA level and serum ALT are important biomarker of disease progression in patients with chronic hepatitis B infection and imperative for consideration in its effective management.

Keywords: Hepatitis B, Hepatitis C, HBV DNA, HBeAg, alanine aminotransferase ALT.

References

  1. Ganem D, Prince CY. Hepatitis B virus infection; natural history and clinical consequences. Engl. J. Med. 2004;350(11):1118-1129.
  2. Dai CY, Yu ML, Chen SC, Lin ZY, Hsieh MY, Wang LY, et al. Clinical evaluation of the COBAS Amplicor HBV monitor test for measuring serum HBV DNA and comparison with the quantiplex branched DNA signal amplification assay in Taiwan. J Clin Pathol 2004; 57:141-145.
  3. Wong GL, Wong VW, Choi PC, Chan AW, Chim AM, Yiu KK, et al. Evaluation of ALT and HBV DNA to predict liver cirrhosis in HBeAg negative chronic hepatitis B infection using transient elastography. Am J Gastroenterol 2008;103(12):3071-3081.
  4. Nita ME, Ciaburo N, Cheinquer H, Italien GL, Evaldo SA, Mantilla P, et al. Patterns of viral load in chronic hepatitis B patients in Brazil and their association with ALT levels and HBeAg status. Ann Hepatol 2009;8(4):339-345.
  5. Bosch FX, Ribes J, Diaz M, Cleries R. Primary liver cancer: worldwide incidence and trends. Gastroenterol 2004; 127(5):5-16.
  6. Perz JF, Armstrong GL, Farrington LA, Hutin YJ, Bell BF. The contributions of hepatitis B virus and hepatitis C virus infections to cirrhosis and primary liver cancer worldwide. J Hepatol 2006; 45(4):529-538
  7. Iregbu KC, Nwajiobi-Princewill PI. Viral load pattern among hepatitis B antigen- positive patients: Laboratory perspective and implications for theraphy. Ann Med Health Sci Res 2016:6:95-99.
  8. Ndububa DA, Ojo OS, Adetiloye VA, Durosinmi MA, Olasode BJ, Famurewa OC, et al. Chronic hepatitis B in Nigerian patients: a study of 70 biopsy proven cases. W afr J Med 2005;24(2):107-111.
  9. Akinbami AA, Oshinaike OO, Dosunmu OA, Adeyemo TA, Adediran A, Akanmu S, et al. Seroprevalence of hepatitis B e antigen and B core antibodies among hepatitis B surface antigen positive blood donors at a tertiary centre in Nigeria. BMC Res Notes 2012; 5:167-172.
  10. Okwuraiwe AP, Salu OB, Onwuamah CK, Amoo OS, Odunukwe NN, Audu RA. Experience with hepatitis B viral load testing in Nigeria. Afr J Clin Exp Microbiol 2011; 12:105-5.
  11. Lesi OA, Kehinde MO, Anomneze EE. Chronic Liver Disease in Lagos: a clinicopathological study. Nig Postgrad Med J. 2004;11(2):91-96.
  12. Mendy ME, Wetzel T, Lesi OA, Hainaut P, Hall AJ, Kuniholm MH et al. Hepatitis B viral load and risk for liver cirrhosis and hepatocellular carcinoma in The Gambia, West Africa. J Viral Hepatitis 2010; 17: 115–122
  1. Olubuyide IO, Ola SO, Dosumu OO, Arotiba JT, Olaleye OA, Odaibo GN, et al. Hepatitis B and C in Doctors and Dentists in Nigeria. Quaterly J Med 1997; 90: 422–1.
  2. Multimer DJ, Olomi A, Skidmore S, Olomu N, Ratcliffe D, Rodger S. Viral hepatitis in Nigeria – sickle cell disease and commercial blood donors. Quaterly J Med 1994; 87: 407–11.
  3. Oluyinka OO, Tong HV, Tien SB, Fagbami AH, Adekanle O, Ojurongbe et al. Occult Hepatitis B virus infection in Nigerian blood donors and Hepatitis B virus transmission risk. PLoS ONE 2015(7): e131912. doi: 10.1371.
  4. Lar PM, Pam VK, Christopher PB, Gwamzhi L, Mawak JD. Prevalence and immune status of HIV/HBV co-infected pregnant women. Afr J Clin Exp Microbiol 2013;14(3):120-126.
  5. Mustapha SK, Jibrin YB. The Prevalence of Hepatitis B surface antigenaemia in patients with Human Immunodeficiency Virus (HIV) infection in Gombe. Niger Ann Afr Med 2004; 3:10-12.
  6. Idoko J, Meloni S, Muazu M, Nimzing L, Badung B, Hawkins C, et al. Impact of hepatitis B virus infection on HIV response to antiretroviral therapy in Nigeria. Clin infect Dis 2009; 49(8): 1268-1273.
  7. Trichopoulos D, Bamia C, Lagiou P, Fedirko V, Trepo E, Jenab M, et al. Hepatocellular carcinoma risk factors and disease burden in a European cohort: a nested case control study. J Natl Cancer Inst 2011;103(22):1686–1695.
  8. Forbi JC, Iperepolu OH, Zungwe T, Agwale SM. Prevalence of Hepatitis B e antigen in chronic HBV carriers in North Central Nigeria. J Health Popul Nutr 2012; 4:377-382.
  9. Ijeoma S, Nwokediuko SC, Onyenekwe B, Ijeoma C: Low prevalence of hepatitis B e antigen in asymptomatic adult subjects with hepatitis B virus infection in Enugu, South East Nigeria. Inter JGastroentorol 2010;10(1):1528-1533
  10. Otegbayo JA, Fasola FA, Abia A: Prevalence of hepatitis B surface and e antigens, risk factors for virus acquisition and serum transaminase among blood donors in Ibadan, Nigeria. Trop Gastroenterol 2003; 24:196–197.
  11. Koyuncuer A. Associations between HBeAg status, HBV DNA, ALT and liver histopathology in patients with chronic hepatitis B. Sci J Clin Med 2014;3:117-123.
  12. Sagnelli E, Stroffolini T, Mele A, Imparato M, Almasio P. Chronic Hepatitis B in Italy: new features of an old disease. Approaching the universal prevalence of Hepatitis B e Antigen negative cases and the eradication of Hepatitis D infection. Clin Infect Dis 2008; 46(1):110–113.
  13. Chen CJ, Yang HI, Su J, Jen CL, You SL, Lu SN, Huang GT, Iloeje UH. REVEAL-HBV Study Group: Risk of hepatocellular carcinoma across a biological gradient of serum hepatitis B virus DNA level. JAMA. 2006; 295(1):65-73.

Corresponding Author

Abdallah Sanda

Consultant Microbiology, Department of Medical Microbiology, Federal Medical Centre, Katsina, Katsina State, Nigeria