Unveiling the Hidden Threat: Occult and Overt Hepatitis B Infection Among Pregnant Women in Edo-North, Nigeria
Hepatitis B is a viral infection that affects the liver, and it can manifest in two distinct forms: occult (HBIOC) and overt (HBIOV). While HBIOC is characterized by the presence of HBV DNA without detectable hepatitis B surface antigen (HBsAg), HBIOV is marked by the presence of HBsAg. Both forms pose significant challenges, especially in vulnerable populations like pregnant women.
Prevalence Among Pregnant Women in Edo-North
A recent study in Edo-North, Nigeria, investigated the prevalence of HBIOC and HBIOV among pregnant women. The study revealed an overall HBV prevalence of 6.0%, with 2.5% diagnosed with HBIOC and 3.5% with HBIOV. Understanding the dynamics between these two forms of HBV is crucial for effective disease management.
Urban Residency and HBV Infection
Urban residency was slightly more common in the HBIOV group (85.7%) compared to the HBIOC group (60.0%), although the difference was not statistically significant (p = 0.45). This finding suggests that urbanization, while offering better access to healthcare services, may not be a primary determinant of HBV infection type. The complexity of urbanization in influencing HBV exposure and management underscores the need for targeted public health strategies.
Education Levels and HBV Infection
Education levels were not significantly different between the two groups. However, a higher proportion of HBIOC participants had tertiary education (60%) compared to HBIOV participants (none). While education is known to influence health-seeking behavior and vaccination awareness, its role in the detectability of HBV infections remains nuanced.
Prior Vaccination and HBV Infection
A significant proportion of both HBIOC (80%) and HBIOV (71.4%) participants reported no prior HBV vaccination. This finding highlights the critical need for comprehensive vaccination programs among pregnant women. Vaccination is a proven preventive measure against HBV infection and transmission.
Risk Factors: Blood Transfusions, Cigarette Exposure, and Alcohol Consumption
Several factors emerged as significant risk factors for HBV prevalence. Participants with a history of blood transfusions were more likely to have HBIOV. This underscores the importance of thorough blood screening protocols, including both HBsAg and nucleic acid testing to detect both occult and overt HBV infections.
Cigarette exposure and alcohol consumption were also significantly associated with HBIOV. Smoking impairs immune responses, potentially facilitating the progression of HBV infection. Chronic alcohol use can exacerbate liver damage, increase viral replication, and enhance the risk of HBIOV, highlighting the need for lifestyle modifications in at-risk populations.
Viral Load and Transmission Risk
Viral load is a critical indicator of HBV activity and transmission risk. The study found significantly higher viral loads in the HBIOV group (4.84 log IU/mL) compared to the HBIOC group (2.30 log IU/mL). Higher viral loads are linked to increased liver damage and transmission risk, underscoring the importance of viral load monitoring in managing HBV infections.
Limitations of the Study
While this study provides valuable insights, its findings may not be generalizable due to its single-center design and the use of convenience sampling. The cross-sectional nature of the study limits causal inferences, and a small sample size may affect the precision of prevalence estimates. Other factors like socioeconomic status and dietary habits were not assessed, limiting a comprehensive understanding of the infection’s progression.
Conclusion
The prevalence of HBV among pregnant women in Edo-North, Nigeria, highlights the need for improved vaccination coverage and lifestyle interventions. Both urbanization and education play a role in HBV detection and management, but comprehensive screening and lifestyle modifications are crucial for preventing and managing HBV infections.
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