DETECTION OF GENOTYPES AND RISK FACTORS

FOR THE TRANSMISSION OF HBV INFECTION IN

PATIENTS ATTENDING GASTROENTEROLOGY
CLINIC IN ENUGU
Nwafia IN, Orabueze IN, Nwachukwu PT, Ebede SO, Nwafia SS, Taiwo SS, Ohanu ME, Ozumba UC

By

Orabueze Ibuchukwu N.
 INTRODUCTION
 Hepatitis B virus infection is highly contagious and poses a serious threat to public health
and security.
 Its infectivity rate is 50-100 times more than that of HIV and 10 times higher than that of
HCV.
 The burden of disease is highest in low-and-middle income countries with associated
significant morbidity and mortality.
 The virus has ten genotypes which have distinct geographical distribution.

 There is a relationship between HBV genotypes, clinical infection, and epidemiological

characteristics.
 This study was aimed at detecting circulating HBV genotypes and risk factors for the
transmission of HBV infection in patients attending UNTH Enugu.
 METHODOLOGY
 This cross-sectional study was carried out among patients attending
gastroenterology clinic in UNTH, Enugu
 Pre-tested structured questionnaires were used to collect relevant
demographic and clinical details
 Serum samples collected from patients were tested for HBV serological
markers using rapid test kits.
 Sanger sequencing was used to detect HBV genotypes and sub-genotypes,
after extraction with QIAamp DNA Mini kit.
 Data was analyzed by both descriptive and inferential statistics using SPSS
version 25.
 P value < 0.05 was considered statistically significant.
 RESULTS
 A total of 151 serum samples were collected, out of which 140(92.7%) samples
were positive for HBV serological markers and were included in this study.
 Out of the 140 participants, 79(56.4%) were males and 61(43.6%) were females.

 Their age ranges from 20 to 89 years and the mean age was 37.33±11.70 years.

 HBV DNA was detected in 63(45.0%), out of which 51 was sequenced

DISTRIBUTION OF HBV GENOTYPES OF STUDY PARTICIPANTS

Genotypes Frequency Percent(%)

A 28 54.9

C 3 5.9

E 20 39.2

Total 51 100
DISTRIBUTION OF HEPATITIS B VIRUS SUB-GENOTYPES

Genotypes Sub-genotypes Number Percent

HBV A/A1 13 46.4

A =28 HBV A/A2 5 17.8

HBV A/A3 10 35.7

C=3 HBV C/C3 3 100

E = 20 ND ND 100

ND- Not detected

CLADOGRAM OF THE HBV SEQUENCES WITH NCB1 MAJOR
GENOTYPE REFERENCE SEQUENCES SHOWING THE MAJOR
CLADES
MULTIVARIATE LOGISTIC REGRESSION RESULT OF
PREDICTIVE FACTORS OF HBV
Factors B S.E. Wald Sig. Exp(B) 95% C.I.for EXP(B)

Lower Upper

Genital Circumcision -.177 .888 .040 0.842 .837 .147 4.778

Education .804 2.666 1.877 0.04** 2.000 -322 9.881

Past Surgical -.063 .782 .007 0.935 .939 .203 4.350

No hepatitis B Vaccination 16.725 12.363 2.001 0.019** 19.63 -.010 1.012

Contact with a known HBV patient .160 1.309 .015 0..903 1.173 .090 15.257

Family History of Liver disease 18.521 87.668 .870 0.598 896.50 .060 10.315
MULTIVARIATE LOGISTIC REGRESSION RESULT OF
PREDICTIVE FACTORS OF HBV

Blood Transfusion -.488 1.418 .118 0..731 .614 .038 9.886

Multiple Sexual partners .702 2.749 1.879 0.035** 2.019 -.465 8.771

Frequent use of condom .286 .759 .142 0..706 1.332 .301 5.895

Sex Workers 18.733 168.235 .000 0.999 136.90 .007 .256

Sexually Transmitted Infection -.735 .853 .742 0.389 .479 .090 2.553

Incision Marks/Tattoo -1.436 1.450 .982 0.322 .238 .014 4.075

Sharing of Sharps/Clippers -1.459 12.088 3.022 .004** 3.713 -.056 1.103

Incarceration -1.730 860 ;001 0.744 378 .401 1.344

DISCUSSION
 The predominant genotype detected was genotype A (A3)
 Uche et al. [1] and Ambachew [2] detected HBV genotype A among blood
donors and chronic HBV patients respectively.
 Ahmad et al. [3] and Opeleye et al. [4] reported predominance of genotype E

 These differences maybe due to: study population, sample size and migration.

 A switch in genotype can occur in chronic HBV patients and this is mainly seen
in people with mixed genotypes.
 Phylogenetic analysis showed that the sequences clustered around Africa, Asia,
and America, suggesting that these patients may have contacted this infection
outside or within Nigeria
 The associated risk factors reported agree with previous studies.[5-7]
 CONCLUSION
 Hepatitis B virus genotypes and sub-genotypes are important because they
can influence the clinical outcome, treatment response and transmission route
 In this study, the genotypes detected were A, C, and E.

 The factors associated with increased risk for HBV transmission were
sharing sharps/clippers, education, and having multiple sexual partners.
 Overall, this calls for increased awareness and targeted preventive measures
that will help actualise the 2030 HBV vaccine driven elimination goal.
 REFERENCES
 Uche EI, Chukwukaodinaka NE, Akinbami AA, Adeyemi OI, Hassan AO, Bamiro RA et
al. Common hepatitis B virus genotypes among blood donors in Lagos, Nigeria. N Post
Med J. 2022; 29: 228-235.
 Opaleye OO, Akanbi OA, Osundare FA, Wang B, Adesina O, Oluremi AS, et al.
Characteristics of hepatitis B and D virus infections among HIV-positive individuals in
South-western Nigeria. Virol J. 2021; 18(1): 20.
 Ambachew H, Zheng M, Pappoe F, Shen J, Xu Y. Genotyping and sero-virological
characterization of hepatitis B virus (HBV) in blood donors, Southern Ethiopia. PLoS
One. 2018; 13(2): e0193177.
 Ito K, Yotsuyanagi H, Yatsuhashi H, Karino Y, Takikawa Y, Saito T, et al. Risk factors for
long-term persistence of serum hepatitis B surface antigen following acute hepatitis B
virus infection in Japanese adults. Hepatology. 2014; 59: 89–97.
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