Journal de bioanalyse et de biomédecine

Evaluation of Some Haemostatic Parameters as Co-Markers to Viral Load in the Management of HBV Infection Treatment Outcome in Delta State, Nigeria

Abstract

Sylvia Ifeoma Obu 1, Grace Ifechukwudelu Amilo 1, Nancy Chiatogu Ibeh 1, Alfred Friday Ehiaghe 1*, Rebecca Chinyelu Chukwuanukwu1, Joy Imuetiyan Ehiaghe 2, Usiosefe Raphael Erhunmwunse 2, Osakue Omoyemen Nosahkare 1 , Samuel Ogenyi 1 and Agiande Oscar Unimnebeshi1

Hepatitis B virus (HBV) infection is a viral infection that affects the liver causing acute as well as chronic disease worldwide. Poor diagnosis and prognostic factors remain one of crucial factors responsible for poor management of the disease despite progress in implementing vaccination programmes and development of new treatment perspectives in the management of hepatitis B virus (HBV) infections which still remain a major health problem worldwide, contributing considerably to cirrhosis- and hepatocellular carcinoma (HCC)-related mortality of 0.5–1 million per year. Thus, this study was aimed at evaluating HBV infection treatment outcome using viral load and changes in haemostatic variables such as activated partial thromboplastin time, prothrombin time, fibrinogen and D-dimer of HBV positive treatment naïve, on treatment at 3 months and treatment at 6 months subjects attending gastro-enterology clinic in Federal Medical Centre Asaba, Delta State, Nigeria. A total of one hundred and fifteen (115) adults aged 22 – 64 years were randomly enlisted in the study. The cross sectional study consist of fifty (50) confirmed hepatitis B negative subjects as negative controls whereas, the follow-up study consist sixty-five (65) treatment naïve HBV positive subjects which were followed-up at three and six months on treatment with tenovofir respectively. Four (4) of the participants (two in three months post treatment and two six months post treatment) dropped-out of the research due to time constrain. The blood samples collected in EDTA was used for platelet count using Sysmex® Automated Hematology Analyzer. Fibrinogen, viral load and D-dimer were analyzed using enzyme-linked immunosorbent assay method. Blood was also anticoagulated with 0.109 M trisodium citrate (9: 1 v/v) for the measurement of activated partial thromboplastin time and prothrombin time. The levels of platelet count did not differ significantly (P >0.05) for the various groups whereas, the median levels of HBV viral load, fibrinogen, D-dimer, prothrombin time and APTT in the HBV naïve, one month post treatment and six month post treatment subjects where significantly higher when compared with the control group ((P <0.05). Thus, is possible that the distortions in synthesis of coagulation proteins in the liver which are reflected in prolongation of PT, APTT, increased D-dimer and low fibrinogen concentration plays a crucial role in pathogenesis HBV infection as such these parameters could be used as co – markers to viral load in monitoring the treatment outcome of HBV infection in Nigeria.