Global epidemiology of occult hepatitis B virus infections in blood donors, a systematic review and meta-analysis

This study aimed to assess the global prevalence of occult hepatitis B in blood donors. We searched PubMed, Web of Science, Global Index Medicus, and Excerpta Medica Database. Study selection and data extraction were performed by at least two independent investigators. Heterogeneity (I2) was assessed using the χ2 test on the Cochran Q statistic and H parameters. Sources of heterogeneity were explored by subgroup analyses. This study is registered with PROSPERO, number CRD42021252787. We included 82 studies in this meta-analysis. The overall prevalence of OBI was 6.2% (95% CI: 5.4–7.1) in HBsAg negative and anti-HBc positive blood donors. Only sporadic cases of OBI were reported in HBsAg negative and anti-HBc negative blood donors. The overall prevalence of OBI was 0.2% (95% CI: 0.1–0.4) in HBsAg negative blood donors. The prevalence of OBI was generally higher in countries with low-income economic status. The results of this study show that despite routine screening of blood donors for hepatitis B, the transmission of HBV by blood remains possible via OBI and/or a seronegative window period; hence there is a need for active surveillance and foremost easier access to molecular tests for the screening of blood donors before transfusion.

Global prevalence and case fatality rate of Enterovirus D68 infections, a systematic review and meta-analysis

A substantial amount of epidemiological data has been reported on Enterovirus D68 (EV-D68) infections after the 2014 outbreak. Our goal was to map the case fatality rate (CFR) and prevalence of current and past EV-D68 infections. We conducted a systematic review (PROSPERO, CRD42021229255) with published articles on EV-68 infections in PubMed, Embase, Web of Science and Global Index Medicus up to January 2021. We determined prevalences using a model random effect. Of the 4,329 articles retrieved from the databases, 89 studies that met the inclusion criteria were from 39 different countries with apparently healthy individuals and patients with acute respiratory infections, acute flaccid myelitis and asthma-related diseases. The CFR estimate revealed occasional deaths (7/1353) related to EV-D68 infections in patients with severe acute respiratory infections. Analyses showed that the combined prevalence of current and past EV-D68 infections was 4% (95% CI = 3.1–5.0) and 66.3% (95% CI = 40.0–88.2), respectively. The highest prevalences were in hospital outbreaks, developed countries, children under 5, after 2014, and in patients with acute flaccid myelitis and asthma-related diseases. The present study shows sporadic deaths linked to severe respiratory EV-D68 infections. The study also highlights a low prevalence of current EV-D68 infections as opposed to the existence of EV-D68 antibodies in almost all participants of the included studies. These findings therefore highlight the need to implement and/or strengthen continuous surveillance of EV-D68 infections in hospitals and in the community for the anticipation of the response to future epidemics.

Enterovirus D68 (EV-D68) infections represent a global public health concern. EV-D68 are detected in apparently healthy subjects and patients with acute respiratory illnesses, acute flaccid myelitis, and asthma-related illnesses. Enterovirus D68 was first described in 1962 and exhibited sporadic circulation until August 2014 when outbreaks of EV-D68 infections were reported in the USA and Canada mainly in children with acute flaccid myelitis and severe acute respiratory disease. We systematically reviewed the literature on EV-D68 infections globally in the present study to determine the case fatality rate and prevalence of current and past infections. Our results show sporadic deaths in patients with severe acute respiratory EV-D68 infections. Our data also show a low prevalence of EV-D68 in current infections unlike the presence of EV-D68 antibodies (past infections) in almost all individuals of all ages. EV-D68 infections were more prevalent in hospital outbreaks, industrialized countries, children < 5 years, and patients with acute flaccid myelitis and asthma-related diseases. These data highlight the need to strengthen the surveillance of EV-D68 infections.

APOBEC3C S188I polymorphism enhances context specific editing of Hepatitis B virus genome

A single nucleotide polymorphism in APOBEC3C (serine to isoleucine in position 188) is present in ~10% of African populations and greatly enhances restriction against HIV-1 and SIV by improving dimerization and DNA processivity of the enzyme. In this study, we demonstrated in culture and in infected patients that HBV could be edited by APOBEC3CS188I. Using next generation sequencing, we demonstrated that APOBEC3CS188I led to an enhanced editing activity in a more specific 5'TpCpA->5'TpTpA context. This constitutes a new hallmark of this enzyme which could be used to determine its impact on HBV or nuclear DNA.

First molecular characterization of the hepatitis E virus in humans in Cameroon: Confirmation of the HEV outbreak in Touboro, North-Cameroon

Hepatitis E virus (HEV) is a major causative agent of acute viral hepatitis in many regions of the world including Africa. In Cameroon, there is no published molecular study on HEV in humans. However, based on serological assays, the first outbreak of HEV was detected in North-Cameroon. The objective of this study was to determine the molecular characterization of HEV that circulated during this period. A retrospective study design was used to select serum samples among those collected during the outbreak period. immunoglobulin M positive samples available in sufficient volumes to amplify HEV RNA were selected. RNA was extracted and then amplified by a real-time reverse transcription polymerase chain reaction (real time RT-PCR) assay, followed by a nested reverse transcription polymerase chain reaction (nested RT-PCR) assay for sequencing and phylogenetic analysis. Overall, 24 samples were selected and HEV RNA was amplified by real-time RT-PCR in 20 samples. Amongst these, 12 samples were positive for HEV RNA by nested RT-PCR and yielded good sequencing products. Phylogenetic analysis showed that 10 samples clustered with HEV genotype 1 (subtype 1e) and two samples clustered with HEV genotype 3 (subtype 3f). This study fills the gap of knowledge on the molecular epidemiology of HEV in Cameroon and confirms the first report of the hepatitis E outbreak in North-Cameroon.

Serological and molecular investigation of hepatitis E virus in pigs reservoirs from Cameroon reveals elevated seroprevalence and presence of genotype 3

Background

Hepatitis E virus (HEV) is a zoonotic pathogen of which pigs have been established as reservoirs. In the present study, we investigated the presence of HEV among pigs in the Center and Littoral regions of Cameroon and performed the molecular characterization of positive strains.

Methodology

A total of 453 serum and stool samples were randomly collected from pigs in slaughterhouses in Obala, Douala and Yaounde. All samples were examined for the presence of anti-HEV IgG and IgM antibodies using ELISA assays. IgM positive stool samples were tested for HEV RNA using an RT-PCR assay, followed by a nested PCR assay for sequencing and phylogenetic analysis.

Results

Overall, 216 samples (47.7%, 95% CI: 43.1%-52.3%) were positive for at least one of the serological markers of HEV infection. Amongst these, 21.0% were positives for anti-HEV IgM, 17.7% for anti-HEV IgG, and 9.1% for both. A total of eight stool samples (5.9%) were positive for HEV RNA by nested RT-PCR. Phylogenetic analysis showed that the retrieved sequences clustered within HEV genotype 3.

Conclusion

This study shows a high prevalence of anti-HEV antibodies and the circulation of genotype 3 in the swine population in Cameroon. Subsequent studies will be needed to elucidate the zoonotic transmission of HEV from pigs to humans in Cameroon.

Evolutionary trends in the prevalence of anti-HDV antibodies among patients positive for HBsAg referred to a national laboratory in Cameroon from 2012 to 2017

Objective

The aim of this study was to update the data on the prevalence of anti-HDV antibodies in Cameroon.

Results

Antibodies against hepatitis Delta virus (Anti-HDV) were found in 16.48% (95% CI 11.46–18.77%) of 426 hepatitis B virus surface antigen positive patients in Cameroon. Remarkably, they were significantly higher among people over 40 years and those living in the East and South regions of Cameroon at 66.7%, 50%, and 40%, respectively. These results suggest that older age and living in areas in the dense forest may be risk factors for Hepatitis D infection.

Detection of hepatitis E virus antibodies among Cercopithecidae and Hominidae monkeys in Cameroon

We screened hepatitis E from 15 species of non-human primates. Anti-HEV IgG was detected in 11.1% (1/9) Mandrillus sphinx, 14.3% (2/14) Gorilla gorilla, 5.9% (4/67) pan troglodytes and 8.7% (2/23) Mandrillus leucophaeus, whereas anti-HEV IgM was detected in 1.5% (1/18) papio Anubis, 28.6% (2/7) Cercocebus agilis and 1.5% (1/67) pan troglodyte.

High seroprevalence of hepatitis E among pigs suggests an animal reservoir in Cameroon

INTRODUCTION

Hepatitis E virus (HEV) is one of the most prevalent cause of acute hepatitis in humans worldwide. The risk of HEV transmission is not limited only to spread from human to human but the infection can also spread from animals to humans, especially from the domestic pigs. Despite mounting evidence regarding the zoonotic potential of porcine HEV infection, there are limited data on its prevalence in pigs in the sub-Sahara Africa region. Therefore, the present study aimed to determine the seroprevalence of HEV antibodies among pigs in two Cameroonian regions.

METHODOLOGY

A total of 162 sera were collected from slaughtered-age pigs from January to March 2012. To determine whether pigs might represent a HEV reservoir in the Northern and Western region in Cameroon, anti-HEV IgG and IgM were tested by ELISA using commercials available kits.

RESULTS

Overall, 70 of the 162 samples (43.2%, 95% CI: 35.5% - 51.2%) were positive for at least one of the serological markers of HEV infection (IgM and / or IgG).We observed a significant seroprevalence of HEV antibodies between the northern and western regions (60% (42/70) and 40% (28/70), p = 0.01796) respectively.

CONCLUSION

Overall, this study reports a high seroprevalence of Hepatitis E virus antibodies in slaughter pigs in Cameroon. Our findings suggest that pigs might be a cause of zoonotic HEV transmission in Cameroon. Therefore, further studies are warranted to establish the dynamics of zoonotic HEV and characterize the different genotypes circulating in humans and pigs.

Droplet digital PCR detects high rate of TP53 R249S mutants in cell-free DNA of middle African patients with hepatocellular carcinoma

Hepatocellular carcinoma (HCC) is still a major killing malignancy in sub-Saharan Africa. Lifelong intoxication with aflatoxin B1 is considered as one of the primary causes of this situation. The role of aflatoxin in HCC from a given population is commonly estimated through the prevalence of R249S mutation of TP53, a hallmark for previous exposure to the mycotoxin. However, the role of AFB1 is barely known in large part of Africa. We conducted a survey on circulating cell-free DNA from 149 patients with HCC and 213 control subjects with and without liver diseases from Cameroon and Central African Republic using droplet digital PCR technique. We observed a mutation prevalence of 24.8% (n = 37/149) in patients with tumor and 5.6% (n = 12/213) in controls (P = 2.2E-07). Patients with mutations usually displayed significantly increased circulating alpha-fetoprotein (AFP) values, high hepatitis B virus (HBV) DNA loads as well as worsened values of blood cells count. Interestingly, the fraction of droplets positive for R249S was significantly larger in patients with liver cancer (15.3 ± 3.7%) than in controls (0.5 ± 0.3%, P = 7.1E-04). Our survey indicates that AFB1 is instrumental for HCC development in Middle Africa and that droplet digital PCR might be used in the region both to diagnose HCC and to conduct public health surveys on populations at risk of chronic aflatoxin intoxication.

Hepatitis E virus infection as a promoting factor for hepatocellular carcinoma in Cameroon: Preliminary Observations

OBJECTIVES

To determine the seroprevalence of hepatitis E virus (HEV) infection in patients with chronic hepatitis and/or hepatocellular carcinoma (HCC) and to assess its potential consequences for disease progression.

METHODS

We conducted a prospective case-control study on patients with HCC hepatitis B or C related and non-HCC patients including patients with CLD and patients without clinical evidence of liver disease. Anti-HEV IgG and IgM were tested by ELISA using commercially available kits. Liver damage was assessed by alanine aminotransferase, aspartate aminotransferase, platelets and prothrombin measurements.

RESULTS

We observed a significant anti-HEV IgG carriage in HCC patients compared to non-HCC subjects with CLD (41.8% vs 12.6%; P=9.1 E-6; OR=4.8, 95%CI: 2.3-10.6). HCC patients with HEV infection display more profound alterations of circulating liver enzymes, platelets count and prothrombin time than HCC patients without sero-reactivity to HEV.

CONCLUSION

Overall, this study indicates a high prevalence of HEV infection in Cameroonian patients with CLD and HCC. These data suggest either that patients with liver tumors are more susceptible to hepeviral infection or that, in a tropical context, HEV might promote the progression of liver diseases towards tumor.