Molecular and Serological Detection of Hepatitis B Virus in Risk Groups and Blood donors inKhartoum state and Determination of Co-infection with Hepatitis C Virus.

This study was carried out in KhartoumState to determine Hepatitis B virus DNA (HBV DNA) by PCR, and to correlate it withserological markers, in samples positive for HBsAg, and to determine sero-prevalence of HBV in Khartoum state using HBsAg ELISA. And to determine sero-prevalence of HCV in HBV patients (co-infection with hepatitis C virus) Blood sample were randamlly collected from 280 blood donors,20 multi-transfused individuals, 100 haemodialysis patients and 80 jaundiced patients. Polymerase chain reaction technique (PCR) was used to detect HBV-DNA using oligonucleotide primers for surface antigen genome region specific (ss genome region specific) and serologic tests for HBV were performed retrospectively. Eleven (68.7%) out of 16 blood donors were positive for HBV-DNA, two (100%) out of 20 multi-transfused patients were positive, 23 (100%) out of 100 haemodialysis patients were positive and 9 (100%) out of 80 jaundiced patients were positive for HBVDNA. More over, the PCR detected two (20%) positive HBV DNA out of 10 samples collected from blood donors that were negative for HBsAg by ICT and ELISA tests. This result suggests that, detection of HBV DNA by amplification technique serves as an important supplementary tool besides serology in a number of clinical settings, especially in determining low levels of viraemia in patients with non-replicative HBV disease and chronic hepatitis, and also ina few patients with past HBV infection who could be asymptomatic carriers of HBV infection. Immuno-chromatography technique (ICT), direct sandwich ELISA test were used to detect HBsAg and indirect ELISA to detect HCV-anti bodies in samples positive for HBsAg. Fifteen (5.3%) out of 100 blood donors were positive for HBsAg by ICT, whereas sixteen (5, 7%) out of 100 blood donors were positive by HBsAg ELISA test. In multitransfused patients only two (10%) outof 20 patients were found positive by both techniques. In haemodialysis patients twenty three (23%) out of 100 patients were found positive by both techniques. In jaundiced patientsnine (11.2%) out of80 patients were found positive by both techniques. In various group studied out of 480 samples.ELISA test was able to detect the presence of HBsAg in 50 (10.4%) individuals.but by using ICT test 49 (10.2%) HBsAg positive individuals were detected. However, there was a very high agreement between ICT and ELISA and no statistical significantdifference was obtained by the application of Stata NT/98 and both assays were sensitive, specific and reliable Also the HCV-antibodies were detectedin samples positive for HBsAg as coinfection in three (6%) out of 50 HBsAg positive. using indirect HCV-ELISA test using recombinant antigens. and ICT test. out of 16 HBsAg positive blood donors. One (6.6%) was positive for HCVantibodies by ICT, whereas two (12.5%) HBsAg positive blood donors were positive by HCV-ELISA test. In haemodialysis group only one (4.3%) out of 23 patients was found positive by both techniques, multi-transfused and jaundiced patients were found negative for HCV-antibodies by both techniques. In this study haemodialysis machine (46%) sharing needles (14%), sexual practice (12%), blood transfused (66%) and probably surgical instruments (30%) represent risk factors for transmission of HBV infection. Tattooing and intravenous drug users seem to have no role in predisposition to the disease in this study. In this study only 4 (8%) patients have background about how HBV is transmitted and how it is prevented. According to the data obtained from the questionnaire this is probably due to the lack of professional and public education. In this study it has been found that infection with hepatitis virus may be predisposedby more than one risk factors