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Epidemiological Insights from HCV and HBV Pilot Studies in Nigeria and Ghana

This presentation discusses pilot data from two studies in Nigeria and Ghana focusing on Hepatitis C virus (HCV) and Hepatitis B virus (HBV). Key findings include higher-than-expected HCV seropositivity and associations with HIV status, alongside analyses of viral genotyping and host genetic variations. Ongoing investigations involve advanced sequencing techniques and assessments of infection rates, with significant implications for public health strategies. The results raise critical questions regarding the discordant results in HBV antigen presence and necessitate further exploration into viral mutations and occult infections.

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Epidemiological Insights from HCV and HBV Pilot Studies in Nigeria and Ghana

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  1. Jennifer Layden, MD, PhDAssistant Professor of Medicine and Public Health SciencesLoyola University Health System

  2. Review of Pilot data • Discuss 2 pilot data sets • Review basic epidemiologic data • Discuss ongoing / planned analyses

  3. Hepatitis Pilot Data from two source populations Subjects enrolled in H3N study (B Tayo) N: 200 ff • Aims: • -chronic/recovered infection rates • -immediate cases/controls for: • -viral genotyping/sequencing • -host genotyping

  4. Data Analysis Plan • Stored samples run in LUMC reference lab • HCV: 4th generation Ab • HBV: Surface Ag • HIV: HIV-1/2 Ab • Aminotransferase level (ALT)

  5. METS CohortPilot Study(N=493)

  6. METS Pilot Study Comparison of HCV Antibody Positive to Negative Population Comparison of HBV S Antigen Positive to Negative Population

  7. Nigeria (H3N) Pilot Study(N=200)

  8. Nigeria Pilot Results Comparison of HCV Antibody Positive to Negative Population Comparison of HBV S Antigen Positive to Negative Population

  9. Logistic Regression:Association with HCV SeropositivityUnivariable Analyses

  10. Logistic Regression:Association with HBV S Ag SeropositivityUnivariable Analyses

  11. Summary of Basic Analysis • Overall higher than expected HCV Sero-positivity in Ghana and Nigeria • Low mean ALT levels • Overall low values • No variation seen by HCV status • Higher values in those with +S Ag • HCV Seropositivity associated with: • HIV + status (>6 OR’s) • HBV S Ag + associated with: • -higher ALT values

  12. Ongoing Analyses • Samples to CDC: • HCV / HBV viral sequencing / genotyping • Viral load measurements • Samples to Duke: • Genotyping of IL28B SNP’s • Association of cleared vs chronic infection • Overall allelic variation

  13. HBV S Antigen / S Gene Sequencing Concordancy Results • S Ag positive: 85 individuals • S Gene positive: 136 individuals

  14. Factors Associated HbSAg and S gene Status

  15. Questions Arising from these results • What contributes to the discordant results? • Is there a high level of occult HBV? • Significance? • Can there be mutations within the SAg causing the low rate?

  16. Current Progress of Pilot Data • CDC based testing: • HBV: Check HBV EAg and EAb, CoreAb, SAb and HBV DNA quant • HCV: Finishing sequencing results • Assess for chronic infection rates • Duke • IL28B genotyping • Allelic variation across SNPs

  17. Kumasi Blood Bank Protocol • Active Enrollment • Re-testing and survey administration to assess risk factors of acquistion

  18. Investigators • LUMC: N Mora, I Berzin, L Dugas, B Tayo, A Luke • METS: A Luke, PhD; J Plange-Rhule, MD, PhD • Nigeria: B Tayo, PhD, B Salako, MD, A Akere, MD • CDC: J Forbi, PhD, Y Khadanov, PhD • Duke: T Urban, PhD, PharmD

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