Evaluation of the Immunological Status in Occult Hepatitis B Virus-infected Patients Attending Rivers State University Teaching Hospital
Baribefe Banavule Daniel Koate *
Haematology Unit, Department of Medical Laboratory Science, Rivers State University, Port Harcourt, Nigeria.
Blessing Didia
Haematology Unit, Department of Medical Laboratory Science, Rivers State University, Port Harcourt, Nigeria.
Tombari Pius Monsi
Microbiology Unit, Department of Medical Laboratory Science, Rivers State University, Port Harcourt, Nigeria.
Zacchaeus Awortu Jeremiah
Haematology Unit, Department of Medical Laboratory Science, Rivers State University, Port Harcourt, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Background: Occult hepatitis B infection (OBI) is a rare form of infection that is characterized by the presence of replication-competent HBV DNA in the liver but without detectable HBsAg in the serum.
Aim: This study aimed to determine the comparative levels of immunological variables particularly CD4 counts and differential white blood cell (WBC) counts in occult hepatitis B and HBsAg positive subjects among prospective blood donors in Port Harcourt Metropolis in Nigeria.
Methods: The CD4 count and total and differential WBC counts were analyzed with automated techniques using BD Fascount and Sysmex XP-300 respectively. Data were analyzed as mean (standard deviation) and significance was assumed at 95% confidence interval using student t-test and one-way ANOVA on GraphPad prism.
Results: The mean values for CD4, WBC, LYM (lymphocyte), MXD (differential mixed cells), and NEU (neutrophils) were 607±286 µ/l, 16±24 /l, 1.8±0.55 %, 0.46±0.15 % and 3.1±1.1 % respectively for occult hepatitis B subjects; 609±222 µ/l, 5.4±1.7 /l, 2.3±1.2 %, 0.54±0.31 % and 2.7±1.2 % respectively for HbsAg positive subjects and 823±256 µ/l, 10±5.4 /l, 2.4±1.6 %, 0.69±0.49 % and 6.4±4.7 % respectively for hepatitis B negative subjects. CD4 levels for male and female occult hepatitis B subjects are 729±309 µ/l and 461±190 µ/l respectively; 582±210 µ/l and 643±250 µ/l respectively for HBsAg positive subjects while that of hepatitis B negative subjects were 824±305 µ/l and 821±199 µ/l respectively. OBI showed a significant negative association between differential mixed cells and lymphocytes (r= -0.89 and p= 0.001) alone signifying that increment in former could reduce the latter. Only the HBsAg positive subjects showed a significant positive correlation of age to differential mixed cells (r=0.94 and p=0.000) which imply as the age increase the level of differential mixed cells will rise. Again, the HBsAg positive subjects showed a significant positive correlation between the differential mixed cells against neutrophil and WBC (r=0.53 and p=0.050), (r=0.56 and 0.036) respectively. Smoking and alcohol consumption caused raised levels of CD4 cells in OBI.
Conclusion: This study revealed a significant decrease in CD4 count, increase in total WBC and neutrophil counts while lymphocyte counts were decreased in occult hepatitis B subjects. Gender difference affect the level of CD4 cells and significant correlation were observed especially with the differential mixed cells.
Keywords: Viral hepatitis, immunological variables, occult hepatitis, CD4 cells