Main Article Content
Aim: Co-infection of hepatitis A, B, C, D, and E viruses may lead to severe morbidity and mortality. This study was conducted to determine prevalence of co-infection of HBV and HEV among animal and non-animal handlers in Osun State, Nigeria.
Study Design: Cross-sectional study.
Place and Duration of Study: Ladoke Akintola University of Technology (LAUTECH), Nigeria, between June 2015 and July 2019.
Methods: A total of 180 blood samples were obtained and screened for Hepatitis B and E virus from cohorts of 90 animal handlers and 90 non-animal handlers. Questionnaires on HBV and HEV were administered to obtain a demographic characteristic of the participants. HBsAg and anti-HEV antibodies were screened using HBsAg and HEV ELISA kits.
Results: Results showed the overall prevalence of HBV and HEV Co-infection to be 12.2 %. There was variation in the HBV/HEV co-infections rates among the studied population, with a co-infection rates of 15.9%, 14.3% and 7.8% for butchers, pig handlers and non-animal handlers, respectively. Sources of drinking water was the predisposition factor for HBV/HEV coinfections (P=0.02). The results revealed that subjects who used tap and river as a drinking water source had the highest prevalence followed by well and sachet and then all water source. Although results portray no statistically significant association with, frequent washing of hands after, rearing of animal, type of toilet, eating of pork, consumption of grilled meat and cow skin (P> 0.05).
Conclusion: This study reported a high prevalence of HBV/HEV coinfections among animal and non-animal handlers in Osun State, Nigeria. There is, therefore, the need to increase health promotion efforts such as immunization, health education, campaign, provision of adequate blood screening equipment and proper hygiene is recommended for further reduction in HBV/HEV transmission. Since the consumption of contaminated water is the main transmission route of HEV, improving the level of public health sanitation in the area should be considered a priority by policymakers.
Martin A, Lemon SM. Hepatitis a virus: From discovery to vaccines. Hepatology. 2006;43(S1):S164–172.
Thuener J. Hepatitis A and B Infections. Prim Care. 2017;44(4):621–629.
World Health Organization (WHO). Hepatitis. Sixty-seventh World health assembly. Agenda Item. 2014;12(3).
Accessed April 20, 2015.
Musa B, Bussell S, Borodo M, Samaila A, Femi O. Prevalence of hepatitis B virus infection in Nigeria, 2000-2013: A systematic review and meta-analysis. Nigerian Journal of Clinical Practice. 2015; 18(2):163-172.
Dagnew M, Belachew A, Tiruneh M. et al. Hepatitis E virus infection among pregnant women in Africa: Systematic review and meta-analysis. BMC Infectious Diseases. 2019;19:519.
Bazerbachi F, Haffar S, Garg SK, Lake JR. Extra-hepatic manifestations associated with hepatitis E virus infection: A comprehensive review of the literature. Gastroenterology. 2016;4(1):1–15.
Rein DB, Stevens GA, Theaker J, Wittenborn JS, Wiersma ST. The global burden of hepatitis e virus genotypes 1 and 2 in 2005. Hepatology. 2012;55(4):988-997.
World Health Organization (WHO). Hepatitis E. Fact sheet. Geneva: WHO; 2018.
Purcell RH, Engle RE, Rood MP. Hepatitis E virus in rats, Los Angeles, California, USA. Emerging Infectious Diseases, 2011; 17:2216-2222.
Cossaboom CM, Córdoba L, Dryman BA, Meng XJ. Hepatitis E virus in rabbits, Virginia, USA. Emerging Infectious Diseases. 2011;17:2047-2049.
Huang YT, Yang HI, Liu J, Lee MH, Freeman JR, Chen CJ. Mediation analysis of Hepatitis B and C in relation to hepatocellular carcinoma Risk. Epidemiology. 2016;27:14-20.
Tsega E, Krawczynski K, Hansson BG, Nordenfelt E, Negusse Y, Alemu W, et al. Outbreak of acute hepatitis E virus infection among military personnel in northern Ethiopia. Journal of Medical of Virology. 1991;34:232–6.
Mushahwar IK, Dawson GJ, Bile KM, Magnius LO. Serological studies of an enterically transmitted non-a, non-B hepatitis in Somalia. Journal of Medical of Virology. 1993;40:218–221.
Benjelloun S, Bahbouhi B, Bouchrit N, Cherkaoui L, Hda N, Coursaget P, et al. Outbreak of enterically-transmitted hepatitis due to hepatitis a and hepatitis E viruses. Journal of Hepatology, 1998;28: 745–750.
Nicand E, Armstrong GL, Enouf V, Guthmann JP, Guerin JP, Caron M, et al. Genetic heterogeneity of hepatitis E virus in Darfur, Sudan, and neighboring Chad. J Med Virol. 2005;77:519–521.
Dagnew M, Belachew A, Tiruneh M, Moges F. Hepatitis E virus infection among pregnant women in Africa: Systematic review and meta-analysis. BMC Infectious Diseases. 2019;19:519.
Howard CM, Handzel T, Hill VR, Grytdal S P, Blanton C, Kamili S, Drobeniuc J, Hu D, Teshale E. Novel risk factors associated with hepatitis E virus infection in a large outbreak in northern Uganda: Results from a case-control study and environmental analysis. American Journal of Tropical of Medicine and Hygiene. 2010;83:1170.
Meng XJ, Wiseman B, Elvinger F, Guenette DK, Toth TE, Engle RE, Emerson SU, Purcell RH. Prevalence of antibodies to hepatitis E virus in veterinarians working with swine and in normal blood donors in the United States and other countries. Journal of Clinical Microbiology. 2002;40:117–122.
Matsubayashi K, Nagaoka Y, Sakata H, Sato S, Fukai K, Kato T, Takahashi K, Mishiro S, Imai M, Takeda N, et al. Transfusion-transmitted hepatitis E caused by apparently indigenous hepatitis E virus strain in Hokkaido, Japan. Transfusion. 2004; 44(6):934–940.
Tedder RS, Tettmar KI, Brailsford SR, Said B, Ushiro-Lumb I, Kitchen A, Morgan D, Lattimore S, Tossell J, Ijaz S, et al. Virology, serology, and demography of hepatitis E viremic blood donors in South East England. Transfusion. 2016; 56(6pt2): 1529–1536.
Farshadpour F, Taherkhani R, Ravanbod MR, Eghbali SS, Taherkhani S, Mahdavi E. Prevalence, risk factors and molecular evaluation of hepatitis E virus infection among pregnant women resident in the northern shores of Persian gulf, Iran. PLoS One. 2018;13(1):e0191090.
Niya MHK, Rezaee-Zavareh MS, Ranaei A, Alavian SM. Hepatitis E virus seroprevalence rate among eastern Mediterranean and middle eastern countries; A systematic review and pooled analysis. Microbiology and Pathology. 2017;110:252–256.
Ghezeldasht SA, Miri R, Hedayatimoghadam M, Shamsian A, Bidkhori H, Fathimoghadam F, Rezaee SA. Population movement and virus spreading: HEV spreading in a pilgrimage city, Mashhad in Northeast Iran; An example. Hepatology Mon. 2013;13(8):e10255.
Ojide CK, Kalu EI, Ogbaini-Emevon E, Nwadike VU. Co-infections of hepatitis Band C with human immunodeficiency virus among adult patients attending human immunodeficiency virus out-patients clinic in Benin City, Nigeria. Nigerian Journal of Clinical Practices. 2015;18:516-521.
Mengesha E, Airgecho T, Negera E, Mulugeta Kebede M. Prevalence of triple viral infections of Human Immunodeficiency Virus (HIV), hepatitis Band C among tuberculosis patients and associated risk factors: The case of West Arsi Zone, Ethiopia. African Journal of Microbiology Research. 2015; 9(26):1675–1683.
Omalu IC, Jibrin LC, Olayemi IK, Hassan IS, Mgbemena C, Mgbemena A, Adeniran LA. Seroprevalence of malaria and hepatitis B (HBsAg) with associated risk factors among pregnant women attending antenatal clinic in General Hospital Minna, North - Central Nigeria. Annual Review & Research in Biology. 2012; 2(4):83-88.
Shen FC, Su IJ, Wu HC, Hsieh YU, Yao WJ, Young KC, Chang TC, Hsieh HC, Tsai HN, Huang W. A pre-S genes chip to detect pre-S deletions in hepatitis B virus large Surface antigen as a predictive marker for hepatoma risk in chronic hepatitis B virus carriers. Journal of Biomedicine Sciences. 2009;16:84.
Colson P, Romanet P, Moal V, Borentain P, Purgus R, Benezech A. Autochthonous infections with hepatitis E virus genotype 4, France. Emerging Infectious Diseases. 2012;18(8):1361-1364.
Choi JY, Lee JM, Jo YW, Min HJ, Kim HJ, Jung WT, Lee OJ, Yun H, Yoon YS. Genotype-4 hepatitis E in a human after ingesting roe deer meat in South Korea. Clinical Molecular Hepatology. 2013;19(3): 309-314.
Coursaget P, Buisson Y, N’gawara MN, Van Cuyck-Gandre H, and Roue R. Role of Hepatitis E Virus in Sporadic Cases of Acute and Fulminant Hepatitis in An Endemic Area (Chad). American Journal of Tropical Medicine and Hygiene. 1998; 58(3):330–334.
Nim J, Archana K, Roberto C, Francesco, M. Prevalence of Hepatitis E and Hepatitis B dual Infection, North India (Delhi). ACTA BIOMEDICINE. 2012;83:197-201.
Ola SO, Odaibo GN, Olaleye OD, Ayoola EA. Hepatitis B and E viral infections among Nigerian healthcare workers. African Journal of Medicine and Medical Sciences. 2012;41(4):387-391.
Asaei S, Ziyaeyan M, Moeini M, Jamalidoust M, Behzadi MA. Seroprevalence of hepatitis a and E virus infections among healthy population in Shiraz, Southern Iran. Jundishapur Journal of Microbiology. 2015;8(7):e19311.
Hesamizadeh K, Sharafi H, Keyvani H, Alavian SM, Shabankareh AN-T, Olyaie RS, Keshvari M. Hepatitis A virus and hepatitis E virus seroprevalence among blood donors in Tehran, Iran. Hepatology Mon. 2016;16(1):e32215.
Wang M, Fu P, Yin Y, He M, Liu Y. Acute, recent and past HEV infection among voluntary blood donors in China: A systematic review and meta-analysis. PLoS One. 2016; 11(9):e0161089.
Khuroo MS, Rustgi VK, Dawson GJ, Mushahwar IK, Yattoo GN, Kamili S, Khan BA. Spectrum of hepatitis E virus infection in India. Journal of Medical Virology. 1994; 43:281–286.
Arora NK, Nanda SK, Gulati S, Ansari IH, Chawla MK, Gupta SD, Panda SK. Acute viral hepatitis type E, A, and B singly and in combination in acute liver failure in children in north India. Journal of Medical Virology. 1996;48:215–221.
Amar N, Dalton HR, Abravanel F, Izopet J. Hepatitis E virus infection. Clinical Microbiology Reviews. 2014;27(1):116–138.