Missed Serologic Diagnosis of Hepatitis B Virus Infection among Blood Donors in Benue State University Teaching Hospital, Makurdi, Nigeria

Background: Serologic undetected Hepatitis B Virus infections have posed a significant global threat in blood transfusion with attendant active liver disease.

Objective: To detect occult Hepatitis B Virus infection (OBI) in subjects with Hepatitis B surface antigen negative-sera.

Methodology: One hundred and seventy (170) serum samples were randomly collected from leftovers of the hepatitis B surface antigen (HBsAg) seronegative tested blood samples belonging to anonymous blood donors in the blood bank unit of Benue State University Teaching Hospital, Makurdi. Fifty HBsAg positive samples were employed as controls. The serum samples were tested for Hepatitis B Virus serologic profiles such as an anti-HBs antibody, anti- HB core antibody and anti-HBe antibody by HBV combination immune-chromatographic rapid kits manufactured by Acumen Diagnostics Incorporated (Lot SAG91108; expiry date 12/2018) and compared with results detected from nested polymerase chain reaction carried out.

Results: Hepatitis B Viral DNA (<50 copies/ml) was detected in 5.9% (n=10/170) total HBsAg negative samples as OBI; 71.0% (n=120/170) of total HBsAg negative samples was positive for anti- HBs antibody; 15.3% (n=26/170) was positive for anti- HBe antibody; 8.2% (n=14/170) was sero-positive for Hepatitis Bcore antibody (anti-HBcore). Out of the 10 OBI positive samples, 100.0% (n=10/10) was sero-positive for Hepatitis B core antibody (anti-HBcore); 60.0% (n=6/10) positive for anti-HBs antibody and 30.0% (n=3/10)HBeAg.

Conclusion: Our findings showed a 5.9% prevalence rate of Occult Hepatitis B Virus infection (OBI) among blood donors in Benue State University Teaching Hospital, Makurdi, Nigeria.

However, Hepatitis B Virus core antibody (anti- HBc) serologic screening test could have unmasked this hidden diagnosis. Hence anti-HBc antibody serologic screening test should be made a mandatory serologic test for every subject with HBsAg negative sample serum wishing to donate blood in low economic settings where Nucleic acid testing is not easily affordable.