PREVALENCE OF HEPATITIS B AND C VIRAL INFECTIONS IN CHILDREN WITH SICKLE CELL ANAEMIA IN USMANU DANFODIYO UNIVERSITY TEACHING HOSPITAL, SOKOTO, NIGERIA

Abstract

Hepatitis B and C viruses are of high interest in Sickle Cell Anaemia (SCA) patients. SCA patients are chronic blood recipients and therefore, prone to infections by these viruses which may worsens their health especially if they developed liver cirrhosis or hepatocellular carcinoma (HCC). This cross – sectional study was undertaken with aim of determining the seroprevalence of Hepatitis B surface Antigen (HBsAg) and Hepatitis C viral antibody (antiHCV) among paediatric patients with homozygous haemoglobin S (HbSS) both in steady state and in crisis and comparing these with those children with haemoglobin AA (HbAA); who served as the control group. Age-specific prevalence rates of HBsAg and anti-HCV among children (6 months – 15 years) with HbSS and those with HbAA were determined. The relationship between frequency of blood transfusion, sources of blood transfusion and other risks factors, and the prevalence of hepatitis B and C selected viral markers (HBsAg and antiHCV) in sickle cell anaemia (SCA) patients and controls was determined. Three hundred (300) SCA children aged 6 months – 15 years attending the SCA clinic and on admission in emergency paediatric unit (EPU) and paediatric medical ward (PMW), (both in steady state and in crises) of the Usmanu Danfodiyo University Teaching Hospital, Sokoto, were screened for both hepatitis B and C infections using HBsAg and anti-HCV as markers of infection. The sensitive Enzyme Linked Immunosorbent Assay (ELISA) method was used for the detection of the markers. Three hundred (300) children with minor illness attending paediatric outpatient Department (POPD) and on admission in EPU/PMW for various treatment of the same hospital served as gender and age matched controls. The results showed that the prevalence of HBsAg seropositivity for hepatitis B virus (HBV) infection among SCA children was 17.3% (52/300) compared to 10.7% (32/300) of the control. The difference was not statistically significant (p = 0.0875). The prevalence of anti-HCV seropositivity for hepatitis C virus infection among SCA children was 12.7% (38/300) compared to 10.3% (31/300) of the controls. The difference was not statistically significant (p = 0.0958). The prevalence of both markers (HBsAg and anti-HCV) for both hepatitis B and C co-infection among SCA children was 3.3%

(10/300) compared with 2.6% (8/300) in controls. The difference was also not statistically significant (p= 0.962). The peak prevalence age group for HBV infection among SCA children was in the age group of 1.1 – 5.0 years (6%) compared to 10.1 – 15.0 years (4.7%) in the control. While the peak prevalence age group for HCV infection among SCA children was 5.110.0 years (8.7%) compared with 10.1-15.0 years (5%) in controls. The rate of blood transfusion was significantly higher among SCA children (48%, {144/300}) compared with controls (21.7%, {65/300}), p = 0.0001. A relationship was observed between mean frequency of blood transfusion and HBV infection among SCA children. There was statistically significant difference between SCA children compared with control in terms of frequency of blood transfusions and seropositivity for anti-HCV (p = 0.016). More than two-thirds (80.6%) of blood transfusions among SCA children were in the tertiary hospital. Another significant relationship was observed between history of injections and seropositivity of anti-HCV among SCA children and controls (p = 0.0001). The immunization rate against HBV in both SCA children and control was zero with high prevalences of HBsAg seroposititvity among SCA children and controls of 17.3% and 10.7% respectively. In conclusion, this study has shown that hepatitis B and C viral infections are common in Sokoto and blood transfusion plays an important role in the prevalence especially of HCV infection in SCA children. Another risk factor was injections and traditional scarification that plays a role in the carrier rate of hepatitis C infections. It is therefore, recommended that strict adherence to immunization against HBV and blood screening practices for both HBV and HCV in both tertiary and outside tertiary hospitals should be enforced, and use and re-use of unsterilized needles and syringes for unsafe injections should be totally avoided or prohibited and traditional scarification should be discouraged.

PREVALENCE OF HEPATITIS B AND C VIRAL INFECTIONS IN CHILDREN WITH SICKLE CELL ANAEMIA IN USMANU DANFODIYO UNIVERSITY TEACHING HOSPITAL, SOKOTO, NIGERIA