Seroprevalence and genotypic characterization of HBV among low risk voluntary blood donors in Nairobi, Kenya
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RESEARCH
Seroprevalence and genotypic characterization of HBV among low risk voluntary blood donors in Nairobi, Kenya Patrick Okoti Aluora1,2* , Margaret Wangui Muturi2 and George Gachara2
Abstract Background: 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. This study therefore sought to determine the serologic and genotypic profiles of HBV circulating among the voluntary blood donors in Nairobi. Methods: Blood 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. Results: A 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. Conclusion: There is a high prevalence of occult HBV infections among these blood donors and therefore the testing platform currently in use requires revision. Keywords: Occult HBV infection, Hepatitis, Liver cirrhosis, Hepatocellular carcinoma, Mutations, Escape mutations, Undetectable Background Globally, 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 therefore at risk of *Correspondence: [email protected] 1 Department of Health and Applied Sciences, Nairobi Technical Training Institute, Nairobi, Kenya Full list of author information is available at the end of the article
HBV related complications. These complications include liver cirrhosis and hepatocellular carcinoma. Sub Saharan Africa records the highest HBV prevalence in Africa with prevalence varying from one country to another [1– 3]. In Kenya, studies among different risk groups report prevalence between 5 and 30% [4]. The studied groups in Kenya so far have included drug users, pregnant women, children attending post natal clinics,
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