Hepatitis B surface antigenaemia among transfused children with sickle cell anemia in Ilorin, Nigeria

Viral hepatitis is a major cause of morbidity and mortality in Sub-Saharan Africa. Hepatitis B virus (HBV) infection is a major disease of serious public health concerns commonly encountered in developing countries. It remains an important cause of chronic liver disease and liver cancer worldwide. Presence of Hepatitis B surface antigen (HBsAg) in the blood indicates an infection with HBV. Patients with Sickle cell anemia (SCA), a common hematological disorder in Nigeria, may have complications that require blood transfusion thus exposing them to the risk. This study therefore determined the prevalence of Hepatitis B surface antigen among transfused children with Sickle Cell Anemia (SCA) in Ilorin. One hundred and ten transfused SCA children aged 6 months to 14 years with age matched controls were recruited consecutively over a one year period, from February 2008 to January 2009. Hepatitis B surface antigen screening was done using a second generation ELISA method. The overall prevalence was 17.7%. There was statistically significant difference in the HBsAg positivity among transfused (23.6%) when compared to non transfused SCA children (11.8%) (p = 0.03). The risk of HBV infection increased with increase in number of transfusion. More subjects in the lower social class were positive than their control counterparts (p = 0.07). Transfused SCA patients belong to a high risk group for hepatitis B virus infection compared to the non-transfused population. The risk of HBV infection acquisition increased with higher number of transfusions and the high prevalence of HBsAg among children with SCA in Ilorin is related to blood transfusion. It is therefore recommended that adequate screening be done always before transfusion is undertaken.