Hepatitis B Screening Profile, Epidemiological and Clinical Characteristics in a Highly Endemic Population in Southern Nigeria

Abstract

Background: Viral hepatitis B is a life-threatening condition with global public health implications. It is highly endemic and one of the leading causes of mortality in Africa. There are no screening strategies defined for the general population in Nigeria despite an estimated 19 million Nigerians living with Hepatitis B, and a high prevalence of 11-13%. This study aims to identify indications for Hepatitis B screening, as well as the virologic, radiologic and sociodemographic characteristics of this populace. Methods: This is a cross-sectional review of the viral hepatitis database of Adult Hepatitis B positive patients. The biodata, laboratory and radiological parameters were analyzed using SPSS version 26 and Categorical variables were reported as frequencies and percentages. Continuous variables were reported as means ±SD, and a p-value of ≤0.05 was considered to be statistically significant. Results: The mean age of the 454 hepatitis B positive patients was 38.33±11.16years comprising198(43.8%) females and 255(56.2%) males. All six geopolitical regions of Nigeria were represented in the study with the south-south region having the highest representation of 220 patients. Incidental findings such as pre-employment screening, pre-marriage screening, screening before blood donation, pre-surgery screening for non-Hepatic related diagnosis and public health awareness campaigns accounted for 64% of the indications for screening, 4.4% were diagnosed from the compulsory antenatal screening and 11.3% with advanced liver disease. The majority of patients (94.7%) were HBeAg negative, while HBV DNA levels ranged from <20 to 170,500,000 IU/ml (mean=4,509,723.97 ± 26,264,722.07 IU/ml).  Increased AST and ALT levels were observed in 256 (56.4%) and 193 patients (42.5%) respectively while 22.2% of the study population had radiological evidence of hepatic disorders at initial screening. Conclusion: This study revealed that Hepatitis B infection in Nigeria cuts across all regions and has a gender disparity with more males affected than females. The majority of the participants were diagnosed incidentally or during an illness, highlighting the importance of routine screening. Additionally, the majority of patients had HBeAg-negative chronic Hepatitis B, indicating the need for effective public health strategies to address this prevalent form of the disease.