Journal of Natural Sciences Research ISSN 2224-3186 (Pa er! ISSN 222"-#$21 (%nline! &ol.3' No.

13' 2#13

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Hepatitis B Virus (HBV) Infection among Alcoholic Consumers at a Local Community, North-East Nigeria
Ja(es) N*a+o1,.' )(ina -aha.a 2.' Jose hine %. )(ira 1.'/e00. 1.%laolu1.'1a0itha ). )+an*e1. 1./e art(ent of 2iological Sciences' 3an*(ar+ 4ni5ersit. %(uaran'6wara state. 2./e art(ent of &irolog.' 7e*eral 8ollege of &eterinar. an* 9e*ical 3a0orator. 1echnolog.' &o(' Plateau State' Nigeria. , 8orres on*ing )uthor e- (ail:n*a+o;<.ahoo.co.u+ A!stract )lcohol re(ains the single (ost significant cause of li5er *isease throughout the =estern worl*> which is res onsi0le for a0out 4# ? 8#@ cause of cirrhosis in *ifferent countries. 1his stu*. was therefore carrie* out to in5estigate the sero- re5alence of A2& infection a(ong alcoholics. %ne hun*re* an* thirt. eight (138! alcoholic consu(ers an* fift. ("#! control su0;ects at 2illiri 8o((unit. in 2illiri 3ocal Bo5ern(ent )rea of Bo(0e State were screene* for A2s)g using 8linotech /iagnostic 1hir* Beneration C3IS) 6it. Structure* Duestionnaire was e( lo.e* to o0tain *e(ogra hic *ata of stu*. su0;ects.1he result o0taine* showe* a ositi5it. of 1# (".3@! a(ong the su0;ects screene*. 8onsi*ering gen*er E (3.E@! sero ositi5it. was recor*e* a(ong the alcoholic (ales co( are* to 3 (2.1@! in fe(ales. )ge consi*eration showe* that su0;ects within 21 ? 3# .ears recor*e* 4 (2.1@! re5alence. CDuall. control su0;ects ha* a re5alence of 4 (2.1@!. 8onsi*ering the seru( a(ino transferase ()31! a(ong ositi5e su0;ects screene* 8 (4.3@! recor*e* an ele5ate* )31.1he *ata o0taine* in this stu*. calls for *rastic (easures at curtailing the s rea* of this 5irus' 0ecause of its atten*ant effects on the li5er. )lso' i((uniFation of in*i5i*uals in this co((unit. is highl. reco((en*e*. "ey#or$s: Ae atitis 2 5irus' Infection' )lcoholic consu(ers. % Intro$uction Ae atitis 2 5irus infects the li5er of the ho(ini*ae inclu*ing hu(ans an* causes an infla((ation calle* he atitis. It is a /N) 5irus an* one of the unrelate* 5iruses that cause 5iral he atitis. 1he *isease was originall. +nown as Gseru(H he atitis (2ar+er et al., 1$$6! an* has cause* e i*e(ics in arts of )sia an* )frica. Ae atitis 2 is en*e(ic in 8hina an* 5arious other arts of )sia (=illia(s' 2##6!. 1he ro ortion of the worl*Is o ulation currentl. affecte* with the esti(ate* at 3@ - 6@. S.( to(s of the acute illness cause* 0. the 5irus inclu*e li5er infla((ation' 5o(iting' ;aun*ice an* rarel. *eath. 8hronic he atitis 2 (a. e5entuall. cause li5er cirrhosis an* li5er cancer' a fatal *isease with 5er. oor res onse to current che(othera . (8hang' 2##E!. 1he infection is re5ente* 0. 5accination (Pung a ong et al., 2##E!. Ae atitis 2 5irus infection is esti(ate* to 0e the cause of 3#@ of cirrhosis an* "3@ of li5er cancer in the worl*'(PerF'2##8!.) roJi(atel. 1"-4#@ of atients with chronic A2& will *e5elo cirrhosis' en*-stage li5er failure or he atocellular carcino(a (A88! in their lifeti(e'(3o+ 2##2!.9ost of the *eaths ($4@! were attri0ute* to co( lications. 8hronic infection' such as cirrhosis an* A88' an* onl. 6@ were attri0ute* *irectl. to acute Ae atitis 2' (Bol*stien'et al'2##2!.Ae atocellular carcino(a is the siJth (ost co((on cancer an* the thir* (ost co((on cause of cancer *eath in the worl*'(7erl.'et al 2#1#!.8hronic A2& infection is the (ost co((on cause of A88' accounting for "#@ of A88 cases worl*wi*e an* u to 8#@ of cases in high A2& en*e(ic regions'(2osch'et al 2##4!. 1he ris+ of the worl*Is o ulation li5e in areas of low en*e(icit.' *e5elo ing A88 is greatl. increase* with the *e5elo (ent of cirrhosis. 1hus' the i*eal wa. to *ecrease A2&relate* *eaths is to first re5ent the infection through 5accination an* strategies to re*uce trans(ission an* secon*' to re5ent rogression to cirrhosis an* A88 in those alrea*. infecte*. Ae atitis 2 5irus infection (a. either 0e acute (self-li(iting! or chronic (long stan*ing!' ersons with self-li(iting infection clear the infection' (ore than $"@ of eo le who 0eco(e infecte* as acute or ol*er chil*ren will stage a full reco5er. an* *e5elo rotecti5e i((unit. to the 5irus. Aowe5er onl. "@ new 0orn that acDuire the infection fro( their (other at 0irth will clear the infection. 1hose infecte* 0etween the age of 1 ? 6 .ears' E#@ will clear the infection (6er+ar' 2##"!. 1he li5er which is the largest 5isceral organ' the (ost 5ersatile organ in the 0o*. an* an. con*ition that se5erall. *a(ages the li5er re resent a serious threat to life as it affects al(ost e5er. other s.ste( of the 0o*.. 3i5er has (an. functions which are 5ital to sur5i5al' the. inclu*e: - 1ransfor(ation of foo* into usa0le 0o*. che(icals' filtration of waste 0acteria' oison fro( the 0loo*' hae(atologic regulation' s.nthesis an* secretion of 0ile an* *rug inacti5ation (*etoJification!. 1he li5er also function as a store house for 5arious (inerals' 5ita(ins an* sugar that the 0o*. uses for energ. ()IC' 2##2!. )s a result of these functions' the li5er is 5er. 5ital to sur5i5al. ) nor(al li5er is s(ooth an* fir( to touch 0ut rogressi5e li5er *a(age can lea* to fi0rosis' shrin+age an* har*ening an* for(ation of no*ules (N)1)P' 2##2!. 3i5er in;ur. an* *a(ages such as he atitis' 23

Journal of Natural Sciences Research ISSN 2224-3186 (Pa er! ISSN 222"-#$21 (%nline! &ol.3' No.13' 2#13

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fi0rosis' cirrhosis' ortal h. ertension' he atocellular failure an* he atocellular carcino(a are cause* 0. 5arious factors such as toJins (e.g. *rugs' alcohol' oison an* che(icals! an* infecti5e agents (e.g. so(e 5iruses' 0acteria' arasite! ()0*alla' 2##1> 9artin et al., 2###!. Se5eral e i*e(iologic stu*ies suggest that chronic alcoholics are at ris+ of 5iral infections. 8linical an* 0asic research has *e(onstrate* that alcohol not onl. worsens the natural histor. of chronic 5iral he atitis' li+e he atitis 2 5irus (A2&! 0ut also see(s to interact with the 5iral re lication c.cle lea*ing to an unusual seru( 5irologic rofile an*Kor (o*ification in the seru( concentration of 5iral articles (Nal as et al.' 1$$8!. Se5eral stu*ies ha5e shown that atients with alcoholic cirrhosis showe* e5i*ence of ast or current infection with A2& (ore co((onl. than *i* health. nonalcoholic su0;ects (2assen*ine et al.' 1$83' Bou*eau et al.' 1$81' Inoue' 1$EE an* 9ills et al.' 1$81!. )n alcoholic has 0een *efine* as one who consu(es (ore of alcohol i.e. " flui* oF of wine or 1." flui* ounce (oF! of *istille* s irits an* contain a roJi(atel. #." oF (14 gra(s! of ure alcohol an* these le5el re resents hea5. alcohol inta+e an* t. icall. alcohol a0use (3ie0er' 2##1> Peters et al., 2##2! chronic alcohol inta+e is the (ost freDuent cause of li5er *isease an* accounts for (a;orit. esti(ate* 1##'### alcohol relate* *eaths each .ear (NI)))' 1$$8> )0*alla' 2##1!. )lcohol affects (an. organ inclu*ing the li5er ()IC' 2##2!. )n. one who consu(es eJcessi5e a(ount of alcohol will ha5e li5er *a(age' 0ut (a. not alwa.s *e5elo into cirrhosis. Se5eral 5accines ha5e 0een *e5elo e* for the re5ention of he atitis 2 5irus infection. 1hese rel. on the use of one of the 5iral en5elo e* rotein (he atitis 2 surface antigen!. 1he 5accine was originall. re are* fro( las(a o0taine* fro( atients who ha* long-stan*ing he atitis 2 5irus infection. Aowe5er' reco(0inant /N) technolog. through las(a *eri5e* 5accines is eDuall. effecti5e an* safe (Luc+er(an' 2##6!. Ae atitis 2 surface antigen (a. 0e *etecte* in seru( for se5eral *a.s> this is +nown as 5accine antigenae(ia (9artin-)0cel' et al., 2##4!.Pre5ention of the trans(ission of 5iral he atitis shoul* focus on u0lic enlighten(ent ca( aign to re5ent trans(ission to others an* rotection of those at ris+ grou against the 5irus. (/e Pal(a' 2##2!. & 'etho$ology( 2.1. Stu*. /esign: )lcoholic consu(ers in a local co((unit. North- eastern Nigeria were recruite* for this stu*.. 1he stu*. ensure* that onl. 5olunteers who agree* to alcoholic consu( tion at 5arious stages of life were recruite* for the stu*.. 2.2. Cnrol(ent an* /ata 8ollection: )fter o0taining in- for(e* consent' 5olunteer su0;ects co( lete* a Duestionnaire which was 0ase* (ainl. on the +nowle*ge of ris+ of eJ osure. 1hese Duestionnaires were *istri0ute* an* Mlle* 0. su0;ects through the hel of gui*es where e5er necessar.. Cthical clearance was then o0taine* fro( rele5ant ethical co((ittee 0efore sa( ling co((ence*. 2.3 Sa( le collection: 3(l of 5enous 0loo* was collecte*' *ul. la0ele* an* allowe* to clot an* sera carefull. se arate* into cr.o5ials an* store* at -2#o8 rior use. 2.4 Sa( le assa.K)nal.tical rocess: 1his was carrie* out using the A2s)g CI)' which is a soli* ? hase si(ultaneous san*wich i((une assa.' which e( lo.s (onoclonal anti0o*ies s ecific for A2s)g. 9icrotiter well is coate* with (onoclonal anti0o*ies s ecific for A2s)g. ) seru( s eci(en is a**e* to the anti0o*. coate* (icrotiters wells together with enF.(e con;ugate* ol.clonal anti0o*ies. 2." HBsAg )esting( 8linotech /iagnostics A2s)g CI) 3R/ Beneration was use* for the *etection of A2s)g in seru(.(Proce*ures e( lo.e* in the )ssa. were 0ase* on (anufacturers instructions!. *rinciples( 1he A2s)g CI) is a soli* ? hase si(ultaneous san*wich i((une assa.' which e( lo.s (onoclonal anti0o*ies s ecific for A2s)g. 9icrotiter well are coate* with (onoclonal anti0o*ies s ecific for A2s)g. ) seru( s eci(en is a**e* to the anti0o*. coate* (icrotiters wells together with enF.(e con;ugate* ol.clonal anti0o*ies. A2s)g' if resent' will for( a anti0o*.-A2s)g-anti0o*.-enF.(es co( leJ. 1he late is then washe* to re(o5e un0oun* (aterials. 7inall.' a solution of ARP enF.(e su0strate (192! is a**e* to the wells an* incu0ate*. ) 0lue colour will *e5elo in ro ortion to the a(ount of A2s)g resent in the s eci(en. 1he enF.(e su0strate reaction can sto e* an* the result is 5isualiFe* 0. na+e* e.e or rea* 0. CI) late rea*er for a0sor0ance at the wa5elength of 4"#n(. *reparation( 1est sa( le' control' con;ugate' *istille* water' su0strate alu(inu( 0ag containing tetra(eth.l 0enFi*ine (192! were allowe* to stan* to a(0ient te( erature 0efore use*. Assay( It was strongl. a*5ise* to anal.Fe each s eci(en an* control in *u licate. )ll the reagents shoul* eDuili0rate to roo( te( erature 0efore use*. 1. "#ul was *is ense* on ositi5e as well as negati5e control in *u licate into res ecti5e wells. 2lan+ was set as a 0ac+groun* control' an* "#ul of seru( or las(a sa( les into

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Journal of Natural Sciences Research ISSN 2224-3186 (Pa er! ISSN 222"-#$21 (%nline! &ol.3' No.13' 2#13

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the res ecti5e wells. "#ul CnF.(e con;ugate was a**e* to each well-(iJe* gentl. 0. swirling the (icrotiter late on the 0ench for 2 (inutes. /% N%1 )// CNL-9C 8%NJ4B)1C 1% 1AC 23)N6 =C33. 3. Incu0ate at 3Eo8 for 1 hour (6# (inutes!. 4. Cach well was washe* " ti(es 0. filling each well with *ilute* wash 0uffer' then in5erting the late 5igorousl. to get all water out an* 0loc+ing the ri( of the wells on a0sor0ent a er for a few secon*s. ". 1##ul su0strate solution(192! was a**e* to each well' then incu0ate* at 3Eo8 for 1" (inutes. 6. "#ul sto solution was a**e* to each well to sto the color reaction. Rea* %./ at 4"#n( an* 63#n( with an CI) late rea*er within 1# (inutes. Assay +ali$ity( 4sing the %./ 5alue of the 0lan+ well to correct all the %./ rea*ing fro( the wells' %/ 5alue of ositi5e control shoul* 0e (ore than 1.# an* of negati5e control less than #.1. %therwise' the test is in5ali*. Interpretation of result( Positi5e ( ! 1he ration of %/ 5alue of sa( le N 2.1 %/ 5alue of negati5e control Negati5e (N! 1he ration of %/ 5alue of sa( le O2.1 %/ 5alue of Negati5e control =here NP 1he (ean a0sor0ance of the negati5e controls. PP 1he (ean a0sor0ance of the ositi5e controls. SP 1he a0sor0ance of the test sa( le. If the %/ 5alue of the Negati5e control is less than #.#"' it shoul* 0e re orte* as #.#". If it is (ore than #.#"' it shoul* 0e re orte* that as the actual %/ 5alue (easure*. 8alculation of cut-off 5alue: 1he cut-off 5alue is 2.1JNegati5e (N! 1est result: ) 1est is ositi5e if S N cut off 5alue ) 1est is Negati5e if S O cut off 5alue. 2.6 Statistical )nal.sis. /ata fro( all Duestionnaires o0taine* were entere* into SPSS' 5ersion 16' an* anal.Fe*. =hile le5el of signiMcance was set at PO#.#". 2. , -esults 1a0le 1: Show the *istri0ution of A2& a(ong alcoholics an* non-alcoholic su0;ects. Aighest re5alence of 1# (".3@! was recor*e*' out of a total of 138 alcoholic su0;ects screene* while 4 (2.1@! a(ong the non-alcoholic (control! su0;ects. 1a0le 2: 1he age *istri0ution a(ong alcoholic showe* su0;ect age* 21 ? 3# .ears recor*ing the highest sero re5alence with 4 (2.$@! while the lowest re5alence of 1 (#.E@! was recor*e* a(ong those age* "1 ? 6# .ears. 1a0le 3: show the re5alence of A2& 0ase* on gen*er a(ong alcoholic su0;ects. 1he highest re5alence of A2& a(ong alcoholics was recor*e* a(ong (ale su0;ects with E (".1@! while the fe(ale su0;ects 3 (2.1@!. 1a0le 4: Ris+ factors ut into consi*eration a(ong alcoholic su0;ects showe* that su0;ects with histor. of 0loo* transfusion recor*e* 3 (1.6@! re5alence. Si(ilarl. ris+ factors 0ase* on su0;ects with histor. of surger. showe* a recor* of 1 (2."@!' with P-5alue of PO#.#" or PN#.#". 1a0le ": showe* ris+ factor a(ong control (Non-alcoholic! su0;ects those with histor. of 0loo* transfusion recor*e* 3 (2".#@! ositi5it.. 1a0le 6: 1he seru( aninotransferase le5el recor*e* were 0ase* on the 14 (E.4@! A2s)g ositi5e sa( les' 1# (".4@! showe* a slight ele5ation of li5er enF.(e while 4(1.4@! recor*e* nor(al le5el.

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Journal of Natural Sciences Research ISSN 2224-3186 (Pa er! ISSN 222"-#$21 (%nline! &ol.3' No.13' 2#13

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)a!le %(1otal Nu(0er of Su0;ects screene*. .tatus of su!/ects )otal No of su!/ects )otal No of *ositi+e )otal of Negati+e screene$ screene$ (0) .u!/ects (0) .u!/ects (0) )lcoholics 138 (E3.4! 1# (".3! 128 (68.1! Non-alcoholics (8ontrol "# (26.6! 4 (2.1! 46 (24."! grou ! 1otal 188 (1##! 14 (E.4! 1E4 ($2.6! Q2 P #.3#"' *f P 1' P P#.823' P-5alue O #.#" )a!le &( )ge *istri0ution of A2& infection a(ong alcoholic su0;ects screene* Age range )otal No of su!/ects )otal No of *ositi+e )otal of Negati+e screene$ (0) .u!/ects (0) .u!/ects (0) 21 ? 3# "# (36.2! 4 (2.$! 46 (33.3! 31 ? 4# 3" (2".4! 2 (1."! 33 (23.$! 41 ? "# 26 (18.8! 2 (2.14! 2" (18.2! "1 ? 6# 2# (14."! 1 (#.E! 18 (13.#! 61 ? E# E (".1! 1 (#.E! 6 (4.3! 1otal 138 (1##! 1# (E.3! 128 ($2.E! Q2 P #.4"$' *f P 2' P 5alues P #.E$"' P-5alue N #.#" )a!le ,( /istri0ution of A2& Pre5alence 0ase* on gen*er a(ong ()lcoholic! su0;ects. 1en$er )otal No of su!/ects )otal No of *ositi+e )otal of Negati+e screene$ (0) .u!/ects (0) .u!/ects (0) 9ales 88 (63.8! E (".1! 81 ("8.E! 7e(ales "# (36.2! 3 (2.1! 4E (34.1! 1otal 138 (1##! 1# (E.2! 128 ($2.8! Q2 P #.128' *f P 1' P ?5alues P #.E2#' P-5alue N #.#" )a!le 2( Ris+ factors 0ase* on clinical histor. of )lcoholic su0;ects -is3 4actors )otal No of su!/ects )otal No of *ositi+e )otal of Negati+e screene$ (0) .u!/ects (0) .u!/ects (0) Aistor. of 2loo* 3" (18.6! 3 (1.6! 32 (1E.#! transfusion Aistor. of Surgical 1" (8.#! 1 (#."! 14 (E."! % eration 1otal "# (26.6! 4 (2.1! 46 (24."! Q2 P #.#"2' *f P 1' P 5alue P #.82#' P-5alue O#.#" )a!le 5( Ris+ factors 0ase* on clinical histor. of control (Non-alcoholic! su0;ects -is3 4actors )otal No of su!/ects )otal No of *ositi+e )otal of Negati+e screene$ (0) .u!/ects (5) .u!/ects (0) Aistor. of 2loo* 8 (16.#! 3 (6.#! " (1#.#! transfusion Aistor. of Surgical 4 (8.#! 1 (2.#! 3 (6.#! % eration 1otal 12 (24.#! 4 (8.#! 8 (16.#! Q2 P #.188 ' *f P 1' P 5alue P #.66"' P-5alue N #.#" )a!le 6( /eter(ination 0ase* on total su0;ect of seru( transa(inase le5el on ositi5e su0;ects. .tatus of )otal No of A.) A.) AL) AL) su!/ects .u!/ect (0) A!normal (0) Normal (0) A!normal Normal (0) (0) )lcoholic 1# (".3! 8 (4.3! 2 (1.#! 8 (4.3! 2 (1.#! Non-)lcoholic 4 (2.1! 2 (1.1! 2 (1.#! # (#.#! 4 (2.1! 1otal 14 (E.4! 1# (".4! 4 (2.#! 8 (4.3! 6 (3.1! 5 7iscussion 1he result o0taine* showe* that the freDuenc. of A2& infection in alcoholics in the co((unit. is higher than in non-alcoholics. Aowe5er' acti5e infection (A2s)g ositi5e! was higher in the in*i5i*uals with histor. of alcoholis( than in those without such case histor. or control su0;ects. Aighest re5alence rate of 1# (".3@! out of 138 su0;ects screene* was recor*e* a(ong the alcoholics while 4 (2.1@! was recor*e* a(ong the non-alcoholic su0;ects screene* (1a0le I!. Statistical anal.sis showe* an insignificant 5alue in 0oth grou s (P-

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Journal of Natural Sciences Research ISSN 2224-3186 (Pa er! ISSN 222"-#$21 (%nline! &ol.3' No.13' 2#13

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5alue P #.823!. 1hese fin*ings agrees with the wor+ of Jerrells et al., (2##2! that alcoholis( has a art to la. in 5iral he atitis' since re5alence was higher in +e. su0;ects than in controls'the reason (a. 0e fro( the *ifferent su0stances such as alcohol (/unn et al., 2##"> Jennifer' 2##6!' which can cause 5iral he atitis.)ccor*ing to 2e*ogni' et al., 2##8A2& infection in alcoholic is associate* with faster rogression in li5er in;ur. with an ele5ate* is+ of *e5elo ing cirrhosis in another stu*. con*ucte* 0. 3as+us' . et al., 1$$2 a(ong alcoholics it was foun* that re5alence of A2& is esti(ate* to 0e four fol* higher than in controls. 8onsi*ering age grou ' the highest re5alence of 4 (2.$@! was recor*e* a(ong the age 21 ? 3# .ears' while the lowest 1 (#.E@! was recor*e* a(ong those age "1 ? 6# .ears (1a0le II!.Statistical anal.sis 0etween the age grou s in*icate* no significant *ifferences with P-5alue #.E$" (i.e. P-5alueO#.#"!'1he age grou consi*ere* to ha5e the highest re5alence in this stu*.' agrees with the wor+ of N*a+o et al 2##$ in a si(ilar stu*ies con*ucte* a(ong alcoholics' this coul* also 0e attri0ute* to .outhful eJu0erance an* h. eracti5it. a(ong this age grou . 8onsi*ering gen*er' a higher re5alent was o0ser5e* a(ong (ales with E (".1@! while fe(ale 3 (2.1@! re5alent rate. 1his result corres on*s to the wor+ of 6ra*;en et al., (2##"! who re ort that the re5alence of A2s)g *e en*ing on the cause is foun* higher in (ales than in fe(ales> also it in agree(ent with the re ort of N*a+o et al., 2##$' where a higher re5alence was recor*e* a(ong (ale su0;ects screene*. 1his (ight also 0e attri0ute* to that fact that (en in this localit. consu(e* the local 0rew as sti(ulants 0efore e(0ar+ing on se5eral acti5ities such as far(ing an* others social functions. Ae atitis 2 infection (ight influence the *e5elo (ent of li5er *isease in hea5. *rin+ers in se5eral wa.s. 7irstl.' ersistent infection with A2& (ight otentiate alcohol-in*uce* li5er *a(age' an* there is e5i*ence that this (a. occur at fairl. low alcohol inta+es (&illa et al.' 1$82!. Secon*l.' chronic acti5e he atitis associate* with A2s)g (a. coeJist with alcoholic li5er *isease' an* the two *isease rocesses woul* ro0a0l. result in (ore ra i* rogression to cirrhosis. 1he seru( a(ino transferase le5els recor*e* were 0ase* on the 14 (E.4@! A2s)g ositi5e sa( les screene*' controls inclusi5e of these 1# (".4@! showe* a slight ele5ation of li5er enF.(e> 2ellentani et al., (1$$E! re orte* si(ilar fin*ings which shows a s ora*ic alteration of li5er enF.(es le5el a(ong the ositi5e su0;ects screene*. Aowe5er' accor*ing to Ba(en et al., (2##4! ersistent ele5ation of seru( )31 for (ore than siJ (onths in*icates rogression to chronic he atitis. Conclusion( In conclusion' Ae atitis 2 infection (ight influence the *e5elo (ent of li5er *isease in hea5. *rin+ers in se5eral wa.s' this coul* 0e *ue to the fact that ersistent infection with A2& (ight otentiate alcohol-in*uce* li5er *a(age' an* there is e5i*ence that this (a. occur at fairl. low alcohol inta+es (&illa et al.' 1$82!.CDuall. chronic acti5e he atitis associate* with A2s)g (a. coeJist with alcoholic li5er *isease' an* the two *isease rocesses woul* ro0a0l. result in (ore ra i* rogression to cirrhosis.7ro( our stu*ies'5accination of su0;ects is strongl. a*5ocate* in this co((unit.'while enlighten(ent on the *angers of this infectious agent 0e gi5en consi*era0le attention so as to re*uce the conseDuences of this 5iral infection a(ong the o ulace. 7isclosure 1he authors re ort no conRicts of interests an* *i* not reDuest or recei5e an. for( of Mnancial su ro;ect.

ort for this

Ac3no#le$gment 1he authors ac+nowle*ge the contri0utions of staffs &irolog. /e t.78&931' &o(' for allowing the use of 3a0orator..CDuall.'our gratitu*e goes to the 2iliri 8o((unit. for the willingness of the &olunteers use* in this stu*.. -eferences )0*alla' 9.-. (2##1!: )lcohol an* li5er *isease: )lcohol an* li5er *isease: Pg 1 ? 1$. )IC Phar(aceuticals (2##2!: )lcoholic he atitis: )lter nati5e (e*icine for )lcohol he atitis Pg. 1 ? E. )na 9ota' 7Sti(a Bue*es' Jorge )reias ' 3uciana Pinho' 9argari*a 7onsec 8ar*oso'(2#1#!.)lcohol consu( tion a(ong atients with he atitis 2 infection in northern Portugal consi*ering gen*er an* he atitis 2 5irus genot. e *ifferences. Elsevier Science Direct., 444:2 PP 149-156. 2ar+er' 3.' Shil(an' N.' 9urra.' R. (1$$6!: 1rans(ission of seru( he atitis 1$E#I J)9) 2E6 (1#!: 841 ? 844. 9.7. 2assen*ine' 3. /ella Seta' J. Sal(eron' A.8. 1ho(as' S. Sherloc+'(1$83!Inci*ence of he atitis 2 5irus infection in alcoholic li5er *isease' A2s)g negati5e chronic acti5e li5er *isease an* ri(ar. li5er cell cancer in 2ritain.J. Liver.Ds. 3 . 6"?E# 2attiston' 3.' (oretti' 9.' 1ulissi' P.' 9ichel' 3.' 3unaFFi' B. an* PoFFato' B.' (1$$"!: Ae atitis glutathione *eter(ination after ethanol a*(inistration in rate e5i*ence of the first ass (eta0olis( ethanol. Lifi. Sci.' "6: 241

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Journal of Natural Sciences Research ISSN 2224-3186 (Pa er! ISSN 222"-#$21 (%nline! &ol.3' No.13' 2#13

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? 284. 2ec+' J.' Nassal' 9. (2##E!: Ae atitis 2 5irus re lication. World Jo rnal !astroenteral 13 (1!: 48 ? 64. 2e*ogni' B.' 9ighoul' 9asutt' 7. (2##8!: National course of chronic A8& an* A2& infection an* role of alcohol in the general o ulation the /ion.sos. "#. J. !astroenterol. 2##8: 1#3 (a!: 2248 2ellentani' S.' Saccoccio' B. an* 8osta' B. (1$$E!: /rin+ing ha0it as cofactor of ris+ for alcohol in*uce* li5er *a(age. $%e Dion&sos St d& !ro ' ! t.' P . 84" ? 8"#. 2osch 7Q' Ri0es J' /iaF 9' et al.( 2##4!.Pri(ar. li5er cancer: worl*wi*e inci*ence an* tren*s. !astroenterolo(&.12E("!:S"-S16. 2lu(0erg' 2.' )lter' A.' (1$$6!: 7urther stu*ies on a new hu(an iso reci itis s.ste(. ()ustralian antigen! 2loo* 2E(3!: 2$E ? 3#$. 2lu(0erg' A.' 2aruch' S. (2##2!:1he Aunt for a +iller 5irus. Princeton' NJ: Princeton. 2onino' 7.' %lwerri' 7.' 2runetto' 9.R. (1$$1!: Patho0iolog. of chronic he atitis 5irus infection an* he atocellular carcino(a (A88!. $%e )talian Jo rnal of !actroenterolo(&. 23 (8!: 4$8 ? "#2. 2ouchar*' 9.J.' Schnei*er R.J. (2##4!. 1he enig(atic Q gene of he atitis 2 5irus. J. 5irol. E8 (23!: 12E2"-34 8hang' 9. (2##E!: Ae atitis 2 5irus infection seru(. *etal +eonatal #ed 12 (3!: 16# ? E. 8hees0rough' 9. (2##2!: /istrict la0orator. ractice in tro ical countries art 2 Pg 2"# ? 2"2. 8enter for *isease control an* re5ention. (1$$E!: Reco((en*ation for re5ention an* control of A2& an* A2& relate* chronic *isease (or0i*it. an* (ortalit.. Wee,l& re'ort 4E:1-3$ /ane' /.' 8a(eron' 8.' 2riggs' 9. (1$E#!: &irus-li+e article in seru( of atients with )ustralian )ntigen associate* he atitis lancet (E64$!: 6$" -8 /o(ingo' C. (1$$"!: &iral he atitis 2. fro( 5irolog. to control' a co( rehensi5e re5iew. Phili ine council for Aealth Research an* /e5elo (ent /%S1. P . 146 ? 162. /rosten' Ni iirasch+' 1.' 9anegol*' 8. (2##4!: Pre5alence of he atitis 2 5irus /N) in anti-A2&Positi0eKA2s)g-Negati5e sera correlates with 28& 0ut not AI& serostatus. J. -%in. .irolo(&. 2$: "$ ? 68. /unn' =.' Ja(al' 3.).' 2rown' 3.S.' =iesner' R.A.' 6i(' =.R. an* 9enon' 6.4. (2##"!: 9CI/ accuratel. re*ict (ortalit. in atients with alcoholic he atitis. /e'atolo(&' 41 (2!: 3"3 ? 3"8. C*(on*o' C.7. (1$$6!. 8linical significance of Ae atitis 2. (e* *igest. 2(21!:1#-1" 7erla. J' Shin AR' 2ra. 7' et al.(2#1#! Csti(ates of worl*wi*e 0ur*en of cancer in 2##8: B3%2%8)N 2##8. )nt J -ancer> C. u0 Jun 1E. Bail0ert' 7.' 9an*art' C.' 1iloussi' 7.' 1oilais' P.' 8harne.' P.' (1$E$!: Nucleoti*e seDuence of the he atitis 2 5irus geno(e (su0t. e! clone* in E.coli: +at re 2"1 ("E33!:646-"# Bane(' /.' Prince' ).9. (2##4!: Ae atitis 2 5irus infection ? National histor. an* clinical conseDuences. +. En(l. J. 0ed. 3"# (11!: 1118. Bol*stein S1' Lhou 7' Aa*ler S8' et al.(2##"!.) (athe(atical (o*el to esti(ate glo0al he atitis 2 *isease 0ur*en an* 5accination i( act. )nt. J E'ide#iolo(&. 34(6!:132$-133$. Bou*eau').' 9au as'P.' /u0ois'7.'8oursaget.'P.' 2ougnouJ .'P.(1$81!.Ae atitis 2 infection in alcoholic li5er *isease an* ri(ar. he atocellular carcino(a in 7ranceProg. 9e*. &irol.' 2E> . 26?34. Aowar*' 8.R. (1$86!: 1he 0iolog. of he a*a5iruses. J. !en. .irol. 6E ( t E!: 121" ? 3". Jennifer' 6.J. (2##6!: Aealth s.ste(. In: )*a(' A./. (e*.!> )ll stration enc&clo'edia. Phila*el hia P). Jerrells' 1.R.' 9itchell' 6. an* Paul' 6.J. (2##2!: Influence of ethanol consu( tion on eJ eri(ental 5iral he atitis. "lco%ol -lin. E1'.' 26: 1E34 ? 1E46. 6a.' S.' Loulin' 7. (2##E!: Ae atitis 2 5irus genetic 5aria0ilit. an* e5olution 5irus Res 12E (2!: 164 ? E6. 6er+ar' N. (2##"!: Ae atitis 2 in chil*ren: co( leJities in (anage(ent. Pediatric trans#ission $ ("!: 68" ? $1. 6ra;*en' 9.' 9acna00' B. an* Petric' 9. (2##"!: 1he la0orator. *iagnosis of he atits 2 5irus. -anadian Jo rnal of infectio s a#d 0edical 0icro2iolo(&, 16 (2!: 6" ? E". 3annaccone' 9.' Sitia' B.' Ruggeri' L. (2##E!: A2& athogenesis in ani(al (o*el: recent a*5ance on the role of latelet. J. /e'atol 46 (4!: E1$ ? 26. 3as+us' 1.' Ra*+ows+i' 9.' 3u a' C.' Aor0an' ).' 8ianciara' J.' SlusarcF.+' J. (1$$2!: Pre5alence of 9ar+ers of he atitis 5irus in out- atient alcoholics. J. /e'atol. 1$$2: 1" (1-2!: 1E4. 3ier0er' 8.S. (2##2!: )lcoholic an* he atitis: )lcohol research an* health' 2": 24" ? 2"4. 3ocarnini' S.' (2##4!: 9olecular 5irolog. of he atitis 2 5irus. Se(in. 3i5er' /is. 24 su 1: 3 ? 1#. 3o+ )S.' (2##2!. 8hronic Ae atitis 2. + En(l J 0ed.> 346(22!: 1682-1683. 9ac8allu(' 7.%.' (1$4E!. Ao(ologous seru( Ae atitis. Lancet 2' 6$1 9acSween' R.9.' =ale.' 6.' et al., (2##1!: 3i5er' 2iliar. tract an* ancreas> (uirIs teJt0oo+ of atholog.. (13 e*.!. Pg. E4" ? E8". C*war* )rnol* Pu0lication' 3on*on. 9ora* our' /.' 8arn.' ).' 2hi(' C.' Ae atitis 8: a (ulti lication of acute he atitis in ost transfuse* thalassae(ia chil*ren. Lancet (2##1!: 34" ? 388. 9aritini' 7.A.' %0er' =.8.' Barrison' 8.=.' =elch' 6.' Autchings' R.1.' et al., (2##1!: 1he *igesti5e s.ste(. In

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Journal of Natural Sciences Research ISSN 2224-3186 (Pa er! ISSN 222"-#$21 (%nline! &ol.3' No.13' 2#13

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fun*a(entals of anato(. an* h.siolog. "th e*. Pg. 8E4 ? 8E$. Prentice-Aall' Inc. Pu0lication New Jerse.. 9artin-)ncel.' 8asas'9.3.' 2onet' 2. (2##4!: I( lication of ost 5accination he atitis 2 surface antigenae(ia in the (anage(ent of eJ osure to 0o*. flui*s. )nfec. -ontrol /os'. E'ide#iol 2"(E!: 611-613. National Institute on )lcohol )0use an* )lcoholis( (NI)))! (1$$$!: 1' Ae atitis Infection an* )lcoholic li5er *isease: NIA Bui*e: 1 ? 8. National institute of Aealth (2##4!. 8oncensus *e5elo (ent conference on (anage(ent of Ae atitis 2: !astroenterolo(& 23(8!: 4$8-"#2. Nal as' S. Pol' &. 1he ot' A. L.l0er0erg' P. 2erthelot' 8. 2rechot 319945. CS2R) 1$$E )war* lecture: relationshi 0etween eJcessi5e alcohol *rin+ing an* 5iral infections. "lco%ol and "lco%olis#'J%Jfor* J.9e*icine 33>3 . 2#2?2#6 N*a+o' J.).' %la0o*e' ).%.' Ccheonwu' B.%.N.' Nwan+iti' %.%.' %nwuliri' %.' )naele' J.7.' )+a0ahile' %.I.' %+e+e' an* J.9' 2an*a (2##$!: Pre5alence of he atitis 2 surface antigen (A2s)g! a(ong alcoholic consu(ers at 2assa 3.B.). Plateau State: )nternational Jo rnal of +ational and "''lied Science. " (3!: 2E6 ? 28# PerF J7' )r(strong B3' 7arrington 3)' et al.' (2##6!. 1he contri0utions of he atitis 2 5irus an* Ae atitis 8 5irus infections to cirrhosis an* ri(ar. li5er cancer worl*wi*e. J /e'atolo(&> 4"(4!:"2$-"38. Peters' 9.B.' 1errault' N. (2##2!: )lcohol use an* he atitis 8.J /e'atolo(& 36 (su l!: "22# ? "22". Peter' 9.B.' 1errault'N. (1$$6!: )lcohol use an* he atitis 2. GAe atolog. ositi5e in;ection *rug users in the 4S citiesH. /rug )lcohol *e en*: 8(3! Pu0lic. 9e*. =A% (2##4!. Pung a ong' S.' 6i(' =.R.' oteurucha' J.J. (2##E!: Natural histor. of he atitis 2 5irus infection: an u *ate for clinicians. 0a&o -lin. Proc. 82 (8!: $6E ? E". Renato' /.' Aarol*' S.B. (1$$#!: Ae atitis 5irus in 5irolog.. P 1#8$ ? 11#2. Seff' 3.2. (2##2!: Natural histor. of chronic he atitis. /e'atolo(& 36: 1 ? 1$. Sirisena' N./.' N;o+u' 9.' 3elo+o' J.).' Isa(a*e' C.' 2aran' 8.' Jel e' /.' La(ani' ).' %lowo' S. (2##2!: 8arriage rate of he atitis 2 surface antigen in an ur0an co((unit. in Jos Plateau State. +i(. Post !rad. 0ed Jo rnal $: E ? 1#. 1a.lor' J.9. (2##6!: Ae atitis *elta 5irus-5olog. 344 (1!: E1.6. 1o le.' =.=.8.' =ilson' B.S. (1$$#!: 9icro0iolog. an* (icro0ial infections 8th e*ition P . E4" ? $66. =A% (2##8!: Blo0al re5alence (u *ate!' wee+l. e i*e(iolog. recor*. =orl* Aealth %rganiFation. 1he worl* health re ort. www.who.intKwhrK2##2KanneJKen. )ccesse* 7e0ruar. 2##2 =orl* Aealth %rganiFation. (2##1!. &iral he atitis. W/6 7 ll. &ol. 6#("!: 643. =A%' (2###!: Ae atitis 2 =orl* Aealth %rganiFation &ol. 1# P 2#4. =A% (2###!. Blo0al re5alence (u *ate! wee+l. e i*e(iolog. recor* =ile.' 1.C.' 9c8arth.' 9.' 2rei*i' 3.' 3a.*en' 1.J. (1$$8!: I( act of )lcohol on the histological an* clinical rogression of he atitis 8 infection. /e'atolo(& 28: 8#2 ? 8#$. =illia(s' R. (2##6!: Blo0al 8hallenges in li5er *isease. /e'atolo(& 44 (3!: "21 ? 6. Louli(' 7. (2##6!: New Nucleic aci* *iagnostic tests in 5iral he atitis. Ser # Liver Dis. 26 (4!: 3#$ ? 1E. Luc+er(an').J. (1$$6!. Ae atitis 5iruses. In : 2aroonIs (e*cal (icro0iolog. (2aroonIs et al.' e*s!' 4th e*.' 4ni5ersit. of teJas (e*ical 2ranch

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