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Salu OB, Akinbamiro TF, Orenolu RM, Ishaya OD, Anyanwu RA, Vitowanu OR, Abdullah MA, Olowoyeye AH, Tijani SO, Oyedeji KS, Omilabu SA. Detection of hepatitis viruses in suspected cases of Viral Haemorrhagic Fevers in Nigeria. PLoS One 2024; 19:e0305521. [PMID: 38905317 PMCID: PMC11192311 DOI: 10.1371/journal.pone.0305521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 06/01/2024] [Indexed: 06/23/2024] Open
Abstract
There have been several Viral Hemorrhagic Fever (VHF) outbreaks in Nigeria which remains a public health concern. Despite the increasing number of suspected cases of VHF due to heightened surveillance activities and growing awareness, only a few cases are laboratory-confirmed to be VHF. Routinely, these samples are only tested for Lassa virus and Yellow fever virus with occasional testing for Dengue virus when indicated. The aetiology of the disease in these VHF suspected cases in Nigeria which are negative for Lassa, Yellow fever and Dengue viruses remains a puzzle. Since the clinical features exhibited by suspected VHF cases are like other endemic illnesses such as Hepatitis, there is a need to investigate the diversity and co-infections of hepatitis viruses as differentials and possible co-morbidity in suspected cases of VHFs in Nigeria. A total of three hundred and fifty (350) blood samples of 212 (60.6%) males and 138 (39.4%) females, aged <1-70 years with a mean age of 25 ±14.5, suspected of VHFs and tested negative for Lassa, Yellow fever and Dengue viruses were investigated for Hepatitis A, B, C and E viruses at the Centre for Human and Zoonotic Virology (CHAZVY), College of Medicine, University of Lagos (CMUL) using serologic and molecular techniques. The serologic analysis of these VHF suspected cases samples revealed that 126 (36%) were positive for at least one hepatitis virus. Individual prevalence for each of the hepatitis virus screened for showed that 37 (10.6%), 18 (5.1%) and 71 (20.3%) were positive for HBV, HCV and HEV respectively. All the samples were negative for HAV. A co-infection rate of 11.9% was also observed, with HCV/HEV co-infections being the most prevalent and the Northern region having the greatest burden of infection. The evidence of hepatitis virus infections in suspected cases of VHF was documented. Thus, their associations as co-morbidities and/or mortalities in this category of individuals require further investigations in endemic countries such as Nigeria. Therefore, the possible inclusion of screening for hepatitis viruses and other aetiologic agents that could mimic infections in suspected cases of VHFs in Nigeria should be thoroughly evaluated to guide informed policy on the diagnosis and management of these cases.
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Affiliation(s)
- Olumuyiwa Babalola Salu
- Centre for Human and Zoonotic Virology, Central Research Laboratory, College of Medicine of the University of Lagos, Idi-araba, Lagos, Nigeria
- Department of Medical Microbiology and Parasitology, College of Medicine of the University of Lagos, Idi-Araba, Lagos, Nigeria
| | - Tomilola Feyikemi Akinbamiro
- Department of Medical Microbiology and Parasitology, College of Medicine of the University of Lagos, Idi-Araba, Lagos, Nigeria
| | - Remilekun Mercy Orenolu
- Centre for Human and Zoonotic Virology, Central Research Laboratory, College of Medicine of the University of Lagos, Idi-araba, Lagos, Nigeria
| | - Onyinye Dorothy Ishaya
- Department of Medical Microbiology and Parasitology, College of Medicine of the University of Lagos, Idi-Araba, Lagos, Nigeria
| | - Roosevelt Amaobichukwu Anyanwu
- Centre for Human and Zoonotic Virology, Central Research Laboratory, College of Medicine of the University of Lagos, Idi-araba, Lagos, Nigeria
| | - Olubunmi Rita Vitowanu
- Department of Medical Microbiology and Parasitology, College of Medicine of the University of Lagos, Idi-Araba, Lagos, Nigeria
| | - Maryam Abiodun Abdullah
- Centre for Human and Zoonotic Virology, Central Research Laboratory, College of Medicine of the University of Lagos, Idi-araba, Lagos, Nigeria
| | - Adenike Hellen Olowoyeye
- Department of Medical Microbiology and Parasitology, College of Medicine of the University of Lagos, Idi-Araba, Lagos, Nigeria
| | - Sodiq Olawale Tijani
- Department of Medical Microbiology and Parasitology, College of Medicine of the University of Lagos, Idi-Araba, Lagos, Nigeria
| | - Kolawole Solomon Oyedeji
- Centre for Human and Zoonotic Virology, Central Research Laboratory, College of Medicine of the University of Lagos, Idi-araba, Lagos, Nigeria
- Department of Medical Laboratory Science, College of Medicine of the University of Lagos, Idi-Araba, Lagos, Nigeria
| | - Sunday Aremu Omilabu
- Centre for Human and Zoonotic Virology, Central Research Laboratory, College of Medicine of the University of Lagos, Idi-araba, Lagos, Nigeria
- Department of Medical Microbiology and Parasitology, College of Medicine of the University of Lagos, Idi-Araba, Lagos, Nigeria
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de Marguerite Nombot-Yazenguet MP, Doté JW, Koyaweda GW, Zemingui-Bembete PA, Selekon B, Vickos U, Manirakiza A, Nakoune E, Gouandjika-Vasilache I, Komas NPJ. Hepatitis E outbreak in the health district of Bocaranga-Koui, Central African Republic, 2018-2019. BMC Infect Dis 2024; 24:215. [PMID: 38374096 PMCID: PMC10875899 DOI: 10.1186/s12879-024-09116-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 02/08/2024] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND Hepatitis E virus (HEV) is a major public health disease causing large outbreaks and sporadic cases of acute hepatitis. We investigated an outbreak of HEV infection that occurred in September 2018 in the health district (HD) of Bocaranga-Koui, located in the northwestern part of Central African Republic (CAR). METHODS Blood samples were collected from 352 patients aged 0-85 years suspected to be infected with yellow fever (YF), according to the World Health Organization YF case definition. The notification forms from recorded cases were used. Water consumed in the HD were also collected. Human samples found negative for anti-YF IgM were then tested by ELISA for anti-HEV IgM and IgG antibodies. Positive anti-HEV (IgM and/or IgG) samples and collected water were then subjected to molecular biology tests using a real time RT-PCR assay, followed by a nested RT-PCR assay for sequencing and phylogenetic analysis. RESULTS Of the 352 icterus patients included, anti-HEV IgM was found in 142 people (40.3%) and anti-HEV IgG in 175 (49.7%). Although HEV infection was detected in all age groups, there was a significant difference between the 0-10 age groups and others age groups (P = 0.001). Elevated levels of serum aminotransferase were observed in anti-HEV IgM-positive subjects. Phylogenetic analysis showed HEV genotype 1e in infected patients as well as in the contaminated water. CONCLUSION This epidemic showed that CAR remains an HEV-endemic area. The genotype 1e strain was responsible for the HEV outbreak in Bocaranga-Koui HD. It is necessary to implement basic conditions of hygiene and sanitation to prevent further outbreaks of a HEV epidemics, to facilitate access to clean drinking water for the population, to launch intensive health education for basic hygiene measures, to sett up targeted hygiene promotion activities and, finally, to ensure that formal health care is available.
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Affiliation(s)
| | - Joël Wilfried Doté
- Enteric Viruses and Measles Laboratory, Institut Pasteur de Bangui, PO Box 923, Bangui, Central African Republic
| | - Giscard Wilfried Koyaweda
- Laboratoire National de Biologie Clinique Et de Santé Publique, PO Box 1426, Bangui, Central African Republic
| | | | - Benjamin Selekon
- Arboviruses, Hemorragic Fever Viruses and Zoonosis Virus Laboratory, Institut Pasteur de Bangui, PO Box 923, Bangui, Central African Republic
| | - Ulrich Vickos
- Department of Medicine, Infectious and Tropical Diseases Unit, Hôpital de L'Amitié Sino-Centrafricaine, Bangui, Central African Republic
| | - Alexandre Manirakiza
- Epidemiological Service, Institut Pasteur de Bangui, PO Box 923, Bangui, Central African Republic
| | - Emmanuel Nakoune
- Arboviruses, Hemorragic Fever Viruses and Zoonosis Virus Laboratory, Institut Pasteur de Bangui, PO Box 923, Bangui, Central African Republic
| | - Ionela Gouandjika-Vasilache
- Enteric Viruses and Measles Laboratory, Institut Pasteur de Bangui, PO Box 923, Bangui, Central African Republic
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Boon D, Redd AD, Laeyendecker O, Engle RE, Nguyen H, Ocama P, Boaz I, Ndyanabo A, Kiggundu V, Reynolds SJ, Gray RH, Wawer MJ, Purcell RH, Kirk GD, Quinn TC, Stabinski L. Hepatitis E Virus Seroprevalence and Correlates of Anti-HEV IgG Antibodies in the Rakai District, Uganda. J Infect Dis 2019; 217:785-789. [PMID: 29186448 DOI: 10.1093/infdis/jix610] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 11/22/2017] [Indexed: 11/14/2022] Open
Abstract
A cross-sectional study was conducted of 500 human immunodeficiency virus (HIV)-infected adults frequency matched on age, sex, and community to 500 HIV-uninfected individuals in the Rakai District, Uganda to evaluate seroprevalence of anti-hepatitis E virus (HEV) IgG antibodies. HEV seroprevalence was 47%, and 1 HIV-infected individual was actively infected with a genotype 3 virus. Using modified Poisson regression, male sex (prevalence ratios [PR] = 1.247; 95% confidence interval [CI], 1.071-1.450) and chronic hepatitis B virus infection (PR = 1.377; 95% CI, 1.090-1.738) were associated with HEV seroprevalence. HIV infection status (PR = 0.973; 95% CI, 0.852-1.111) was not associated with HEV seroprevalence. These data suggest there is a large burden of prior exposure to HEV in rural Uganda.
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Affiliation(s)
- Denali Boon
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland.,Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Andrew D Redd
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland.,Division of Infectious Diseases, Department of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Oliver Laeyendecker
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland.,Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.,Division of Infectious Diseases, Department of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Ronald E Engle
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | - Hanh Nguyen
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | - Ponsiano Ocama
- Department of Medicine Makerere University, Kampala, Uganda
| | - Iga Boaz
- Rakai Health Sciences Program, Entebbe, Uganda
| | | | | | - Steven J Reynolds
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland.,Division of Infectious Diseases, Department of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Ronald H Gray
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.,Rakai Health Sciences Program, Entebbe, Uganda
| | - Maria J Wawer
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.,Rakai Health Sciences Program, Entebbe, Uganda
| | - Robert H Purcell
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | - Gregory D Kirk
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Thomas C Quinn
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | - Lara Stabinski
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
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Origin and dispersal of Hepatitis E virus. Emerg Microbes Infect 2018; 7:11. [PMID: 29410449 PMCID: PMC5837148 DOI: 10.1038/s41426-017-0009-6] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 11/17/2017] [Accepted: 12/03/2017] [Indexed: 12/21/2022]
Abstract
Hepatitis E virus (HEV, genus Orthohepevirus) is a common cause of hepatitis worldwide. Human-infecting HEV strains (Orthohepevirus A) include human-restricted and enzootic genotypes. Viruses in the Orthohepevirus A species also infect rabbits (HEV-3ra), camels, and swine. Using a selection-informed method, we dated the origin of the Orthohepevirus genus at least 21 million years ago, whereas the Orthohepevirus A species originated in Asia, most likely from a human-infecting ancestor that existed ~4500 to 6800 years ago. In this period, the appearance of large human settlements probably facilitated HEV emergence and spread. The earliest events in Orthohepevirus A evolutionary history involved the separation of the enzootic and human-restricted genotypes, as well as the split of the camel-infecting genotypes, which occurred during the time-frame of camel domestication. The place and timing of HEV-3ra divergence also correspond to the circumstances of rabbit domestication. This study clarifies the origin and historical events underlying HEV dispersal.
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