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DETECTION OF HEPATITIS C AND HEPATITIS B VIRUS INFECTION AMONG PRISON INMATES AND PSYCHIATRIC PATIENTS

ABSTRACT

There is high risk of contracting hepatitis B and C among individuals with psychotic disorders due to lifestyle factors and prisoners globally continue to demonstrate a higher prevalence of Hepatitis B and C than the general population. This study was aimed at determining the seroprevalence of HCV and HBV and to detect hepatitis C virus (HCV) among prison inmates and psychiatric patients in Kaduna Metropolis. A total of 276 (153 prison inmates and 123 psychiatric patients) serum samples were tested for anti-HCV and Hepatitis B surface antigen (HBsAg) using third generation Enzyme Linked Immunosorbent Assay (ELISA) and RDT method respectively. Hepatitis C virus genome was detected in ten (10) serum samples using reverse transcription polymerase chain reaction (RT-PCR). An overall anti-HCV IgM prevalence of 10.14% (28/276), anti- HCV IgG prevalence of 8.69% (24/276) and HBsAg prevalence of 6.15% (17/276) was established. A 0.36% (1/276) HCV/HBV co-infection rate was obtained. Among the inmates, an anti-HCV IgM and IgG prevalence of 10.45% (16/153) and 8.5% (13/153) respectively was obtained with a 9.2% (14/153) HBsAg prevalence. An HBsAg, anti-HCV IgM and anti-HCV IgG prevalence of 2.4% (3/123), 9.75% (12/123) and 8.9% (11/123) respectively was obtained among the psychiatric patients. The highest HCV antibody prevalence was obtained among the female subjects (14.1% for IgM and 8.4% for IgG). No female tested positive for HBsAg. Subjects aged ≥48 years had the highest HCV prevalence (28.9%: 13/45 for IgM and 31.1%: 14/45 for IgG) while those within age group 28-32 years had the highest HBsAg prevalence (11.7%: 7/60). Age was observed to be associated with HCV infection (p=0.00). Viremia was evaluated by amplifying conserved untranslated region of HCV genome and bands of 244bp were observed. There was no statistically significant association between the viral infections and demographics. Presence of tattoo/scarification and alcohol intake were statistically associated with HCV infection while clothes sharing was associated with HBsAg among the inmates. Hepatitis C virus infection was statistically associated with blood transfusion, alcohol intake, presence of tattoo/scarification, sexual experience and shaving equipment sharing among the psychiatric patients while HBsAg was associated with only clothes sharing. This study established the circulation of HBV and HCV among inmates and psychiatric patients in Kaduna State. These individuals should therefore be screened for these viruses for appropriate clinical management and effective prevention.

INTRODUCTION

Hepatitis C virus (HCV) is a small enveloped virus measuring 55-65nm in size. It is a positive sense single stranded RNA virus of the family Flaviviridae and genus Hepacivirus (Kapoor et al., 2011). It is the causative agent of human hepatitis C infection, although it has been found to infect chimpanzees, dogs, horses, and rodents (Rogo, 2011; Burbelo et al., 2012; Kapoor et al., 2013; Quan et al., 2013). Hepatitis C virus particle is made up of an RNA core of genetic material, surrounded by an icosahedral protective protein. This is further encased in a lipid envelope derived from the host. The viral glycoproteins, E1 and E2 are embedded in the lipid envelope (De-Beeck et al., 2003; Igwe et al., 2010). Hepatitis C virus encodes a single polyprotein of 3010-3011 amino acids which is processed into structural and non-structural proteins (NS). This is made possible with the aid of cell signalases and viral proteases.

Hepatitis C genome consists of a single open reading frame (ORF) that is made up of 9600 nucleotide base long (Kato, 2000). The ORF possess highly conserved nontranslated regions (NTR) in its 5′ and 3′ ends. In the 5′ end, there is an internal ribosome entry site (IRES) which allows the RNA to bind to the ribosomes close to the codon to start codon of the ORF. Based on genetic differences between HCV isolates, the virus is classified into seven genotypes (1-7) (Nakano, 2011). These subtypes are further broken into quasi species based on genetic diversity (Christian, 1996) and high error rate on the part of the virus RNA dependent RNA polymerase. The entry of the virus into the host is as a result of complex interaction between virions and cell surface molecules (Zeisel et al., 2009 Kohaar et al., 2010). The structure and replication of HCV is poorly known due to lack of efficient cell culture system, difficulty to grow or develop in cell culture as well as striking heterogenicity in density (Kawo et al., 2012). The virus replicates mainly in the hepatocytes of the liver, where it is estimated that daily each infected cell produces approximately fifty (50) virions with a calculated total of one trillion virions generated (Bartenschlager and Lohmann, 2000).

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