DOWNLOAD PDF                                                                                    

Assessment of haematological parameter and Liver enzyme among Hepatitis B Infected Blood Donors

Oke Olusegun Taiwo1, Oduntan Sekinat Oluremi1, Olasimbo Godswill Ikuejamoye1, Abdulrahman Abdulbasit Opeyemi1, Olamijuwon Priscilla Busola1, Ayara Peter Ayowole1 and *Emmanuel Ifeanyi Obeagu2

1Department of Medical Laboratory Science, College of Basic Health Sciences, Achievers University Owo, Ondo State, Nigeria

2Department of Medical Laboratory Science, Kampala International University, Uganda.

*Corresponding author: Emmanuel Ifeanyi Obeagu, Department of Medical Laboratory Science, Kampala International University, Uganda, emmanuelobeagu@yahoo.com, 0000-0002-4538-0161

ABSTRACT

Viral hepatitis poses a substantial global health burden. The most often seen abnormalities after the diagnosis of Hepatitis B Virus (HBV) generally encompass haematological abnormalities and changes in liver parameters. The aim of this study is to evaluate the haematological variables and liver enzymes, specifically aspartate transaminase (AST) and alanine transaminase (ALT), among blood donors who have contracted the hepatitis B virus (HBV) at the Federal Medical Centre (FMC) in Owo. The study encompassed a cohort of 70 individuals, with the experimental group comprising 50 individuals who exhibited positive results for the hepatitis B virus (HBV). The control group consisted of a sample of twenty (20) apparently healthy adults. The mean levels of red blood cells (RBC), hematocrit (HCT), haemoglobin (HGB), and platelets (PLT) demonstrated a statistically significant reduction in persons relative to the control group, as evidenced by the p-values of 0.002, 0.001, 0.035, and 0.002, respectively. No statistically significant decrease in the average concentration of white blood cells (WBC) was reported among the participants in comparison to the control group (p=0.236). The study revealed a significantly increased mean concentration of alanine aminotransferase (ALT) in the participants as compared to the control group (p=0.016). The study findings revealed that there was no statistically significant difference in the levels of AST observed between the participants and the control group (p = 0.285). The present study has provided evidence to support the use of haematological parameters and liver enzymes as a reliable and accurate approach for assessing the severity of hepatitis B virus (HBV) infection. Therefore, it is crucial to incorporate the surveillance of patients even after their recovery from hepatitis B virus infection as an essential element of their healthcare.

Keywords: Hepatitis B, Liver, Haematological Parameter, Liver Enzyme

INTRODUCTION

The prevalence of Hepatitis B (HB) infection is a matter of great concern on a global scale, as it has the potential to greatly impact public health [1-4]. The hepatitis B virus (HBV) has exhibited a substantial global prevalence, impacting a population over two billion individuals [5-8]. Moreover, a significant proportion of this affected population, estimated to be between 360 and 400 million individuals, is known to suffer from chronic HBV infection [10-16].  However, it has been determined that the anticipated annual mortality attributable to HB infection spans a range of 0.61 million to one million [17-20]. Furthermore, the annual global incidence of HB infection amounts to around 4.5 million new cases. Notably high prevalence of HBV infection in the Western Pacific and African Region. Specifically, the infection rates among the adult population in both regions were found to be 6.2% and 6.1% respectively [21-25]. Numerous studies have reported the prevalence rates in sub-Saharan Africa, revealing a considerable variation ranging from 3% to 50%. It is worth noting that Nigeria has documented a prevalence rate of 9.5% for hepatitis B infection [26-30].

The liver is accountable for the synthesis of approximately 90% of all proteins, encompassing the entirety of albumin [31-38]. As a result, a notable decrease in blood protein concentrations is found in cases of extensive liver tissue destruction. Liver function tests are diagnostic procedures used to identify, diagnose, and evaluate hepatic diseases. The enzymes aspartate amino-transferase (AST) and alanine aminotransferase (ALT) are intracellular enzymes that are released into the circulation as a result of liver cell membrane disruption, causing the cytoplasmic contents of the cell to be expelled [39-43]. The enzymes alkaline phosphatase (ALP) and gamma glutamyltransferase (GGT) are predominantly localised on the canalicular membrane of hepatocytes. In the event of cholestasis, these enzymes are released into the plasma. The correlation between an elevated alkaline phosphatase (ALP) level and the existence of a cholestatic disease can be verified through an augmentation in gamma-glutamyl transferase (GGT) levels [43-47]. The usage of haematological parameters is a widely employed method for evaluating the overall health status of individuals, since each component plays a vital role in diagnosing particular illnesses such as hypertension and hemostatic disorders [30-40]. The aforementioned criteria are acknowledged to demonstrate variety with respect to aspects such as age, gender, race, geographic location, as well as special circumstances such as pregnancy and certain medical disorders. The measurements listed above demonstrate intra-individual variability, as observed by [9]. Therefore, the main aim of this research is to evaluate the haematological parameters and liver enzymes, specifically aspartate transaminase (AST) and alanine transaminase (ALT), in individuals who have contracted the hepatitis B virus (HBV) and have made blood donations at the Federal Medical Centre (FMC) in Owo.

CONCLUSION

The association between HBV, haematological alterations, and liver function disruption is established in this study. The concentration of haematological parameters in HBV-infected individuals differs from that of healthy individuals, with a significant difference in the levels of HCT, HGB, RBC, and PLT, as well as liver parameters such as ALT and AST. The present study has established that assessment of haematological parameters and liver enzymes is an effective, reliable, and competent way of diagnosing the severity of HBV infection.

RECOMMENDATION

In the present study, variation in the haematological parameters has been observed in patients with the seropositive Hepatitis B virus. This determines the need for routine haematological investigations in acute viral hepatitis patients. The follow-up of patients even after recovery from hepatitis B virus infection should be an essential part of these patients’ management.

REFERENCES

  1. Oyewusi, C. O., Okanlawon, F. A., and Ndikom, C. M. Knowledge and Utilization of Hepatitis B Infection Preventive Measures and Influencing Factors among Health Care Workers in Ibadan, Nigeria. International Journal of Caring Sciences. 2018, 8(1): 164-176.
  2. Abeje, G., and Azage, F. Hepatitis B vaccine knowledge and vaccination status among health care workers of Bahir Dar City Administration, Northwest Ethiopia: a cross sectional study. BMC Infectious Diseases. 2018, 15(1): 30-35.
  3. Abulude OA, Ahmed I, Sadisu FU. Assessment of Hepatitis B Viral Infection as a Predictor of Hepatic Enzymes and Compounds Alteration among Antenatal Patients. Medical Sciences. 2017;5(4):24.
  4. Busayo, I.A., Isabelle, Y., and Brett, A.L. Hepatitis B virus infection in Nigeria: a systematic review and meta-analysis of data published between 2010 and 2019. BioMedical Central Infectious Diseases; 2021, 21(1120):83-91.
  5. Bishop, M., Fody, E., and Schoeff, L. Clinical Chemistry techniques, principles, correlations.6th edition. Mary land: Lippincott Williams & Wilkins, a Wolters Kluwer business; 2020.
  6. Henry, J., Richard, A., and Matthew, R. Henry’s Clinical Diagnosis and Management by Laboratory Methods. 22ndedition. New York: Elsevier Saunders; 2011.
  7. Purohit, G., Shah, T., and Harsoda, J.M. Hematological profile of normal pregnant women in Western India. Scholars Journal of Applied Medical Sciences; 2015, 3:2195-2199.
  8. Sarangi, S.N., and Acharya, S.S. Bleeding disorders in congenital syndromes. Pediatrics; 2017, 139:e20154360
  9. Keramati, M.R., Zadeh, A.M., Farhat, A.S., and Sadeghi, R. Determination of haematologic reference values of neonates in Mashhad Iran. Uluslararasi Hematoloji Onkoloji Dergisi journal; 2011, 21:101-105.
  10. Suzuki T, Okamoto T, Kawai F, Okuyama S, Fukuda K. Hemolytic Anemia after Acute Hepatitis B Virus Infection: A Case Report and Systematic Review. Internal Medicine. 2021;64(4).
  11. Abakar MAA, Kafi SK, Ahmad-Abakur EH, Hammad MMA. Assessment of AST and ALT among Different Clinical Categories of Hbv Infected Individuals at Khartoum State-Sudan. World Journal of Pharmaceutical Research. 2019: 8(5).
  12. Rasheed H, Khawar MB, Habiba U, Aman S, Shah SS, Afzal A. Variations in Peripheral Hematological Parameters as a Diagnostic Biomarker of HBV Infection. Asian Journal of Health Sciences. 2022;8(2):45–5.
  13. Alla J, Muhammad Y, Habeeb A, Mustapha A, Andrew C, Saeed, S. Gender Distribution Of Blood Donors And Bloodrecipients In Rasheed Shekoni Teaching Hospitaldutse, Jigawa State, Nigeria. International Journal of Scientific Research and Engineering Development. 2019:2(1)
  14. Abdullah SM. Prevalence of Hepatitis B and C virus infection and their co-relation with hematological and hepatic parameters in subjects undergoing Premarital Screening in the Jazan Region, Kingdom of Saudi Arabia. Pakistan Journal of Medical Sciences. 2018;34(2).
  15. Mohammad SD, Sonia G, Owais G. Estimation of hematological parameters in patients with Hepatitis B and C. International Archives of Integrated Medicine. 2019: 6(11).
  16. Viky NRM, Puspa W, Bagus S. AST, ALT and Albumin Level in Chronic Hepatitis B Patients with and without Complications of Cirrhosis and Hepatocellular Carcinoma. Indonesia Journal of clinical pathology and medical laboratory. 2020; 26(3).
  17. Fashola EA, Otegbayo JA, Abja UMA, Ola SO. Haematological parameters in Nigerians with acute viral hepatitis. Nigerian Journal of Gastroenterology and Hepatology. 2009;1(1).
  18. Desai H, Ansari AZ, Makwana D, Jadeja D, Gusani J. Clinical-biochemical profile and etiology of acute viral hepatitis in hospitalized young adults at tertiary care center. Journal of Family Medicine and Primary Care. 2020:9(1):247.
  19. Hendren N, Moore JA, Hofmann SL, Siayareh Rambally. Resolution of acute hepatitis B-associated aplastic anaemia with antiviral therapy. Case Reports. 2017 Oct 3 [cited 2023]; bcr-221503. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5652399/
  20. Xue R, Zhu Y, Liu H, Meng Q. The clinical parameters for the diagnosis of hepatitis B virus related acute-on-chronic liver failure with sepsis. Scientific Reports. 2019;9(1).
  21. Jiang H, Li Y, Sheng Q, Dou X. Relationship between Hepatitis B virus infection and platelet production and dysfunction. Platelets. 2021;33(2):1–7.
  22. Obeagu EI, Obeagu GU, Nwosu DC. Hepatitis B and Hepatitis C viral infection: A Review. Int. J. Curr. Res. Chem. Pharm. Sci. 2016;3(11):10-21
  23. Obeagu EI, Obeagu GU. Occult Hepatitis B infection and immunity. Int. J. Curr. Res. Med. Sci. 2017;3(8):89-100.
  24. Obeagu E, Chima CO, Nwosu DC, Dike-Ndudim JN, Ahiara CO, Obeagu EI. Comparative Studies on Hepatitis B Virus Infection in Ebonyi State Nigeria Using HBsAg as indices. Madonna University journal of Medicine and Health Sciences ISSN: 2814-3035. 2022 Mar 3;2(1):159-84.
  25. OkaraGC HS, Obeagu EI. Hepatitis A virus infection among apparently healthy Nigerian Subjects. J Biomedical Sci. 2017; 6:2.
  26. Ezekwe, C. I., Uzomba, C. R., & Ugwu, O. P. C. (2013). The effect of methanol extract of Talinum triangulare (water leaf) on the hematology and some liver parameters of experimental rats. Global Journal of Biotechnology and Biochemistry, 8(2), 51-60.
  27. Nwaka, A. C., Ikechi-Agba, M. C., Okechukwu, P. U., Igwenyi, I. O., Agbafor, K. N., Orji, O. U., & Ezugwu, A. L. (2015). The effects of ethanol extracts of Jatropha curcas on some hematological parameters of chloroform intoxicated rats. American-Eurasian Journal of Scientific Research, 10(1), 45-49.
  28. Enechi, O. C., Okpe, C. C., Ibe, G. N., Omeje, K. O., & Ugwu Okechukwu, P. C. (2016). Effect of Buchholzia coriacea methanol extract on haematological indices and liver function parameters in Plasmodium berghei-infected mice. Global Veterinaria, 16(1), 57-66.
  29. Ezekwe, C. I., Okoro, I. J., Ugwu, P. C., & Ezea, S. C. (2013). The effect of methanol extract of Talinum triangulareon some selected hematological and Kidney parameters of experimental rats. World J Pharm Pharm Sci, 2(6), 4383-4396. Obioma, B. E., Okechukwu, P. U., Emmanuel, I. O., & Ifemeje, J. C. (2014). Antianaemic potential of aqueous leaf extract of Mucuna pruriens on wister albino rats.  J. Curr. Microbiol. App. Sci, 3(1), 707-712.
  30. Chukwuemeka, I., Utuk, G. S., Ugwu Okechukwu, P. C., Ibiam, U. A., Aja, P. M., & Offor, C. E. (2015). The effect of ethanol leaf extract of Jatropha curcas on some haematological parameters of cyclophosphomide induced anaemia in wister albino rats. European Journal of Applied Sciences, 7(1), 17-20.
  31. Offor, S. C. E., Ukpabi, E. N., Ogbanshi, M. E., Okechukwu, P. U., & Nwali, B. U. (2014). The effects of ethanol leaf-extract of Anacardium occidentale on haemoglobin and packed cell volume of albino rats. World Journal of Alternative Medicine, 1(1), 05-08.
  32. Adonu, C. C., Ugwu, O. P., Bawa, A., Ossai, E. C., & Nwaka, A. C. (2013). Intrinsic blood coagulation studies in patients suffering from both diabetes and hypertension. Int J Pharm Med Bio Sci, 2(2), 36-45.
  33. Offor, C. E., Okaka, A. N. C., Ogbugo, S. O., Egwu, C. O., & Ugwu, P. C. Effects of ethanol leaf extract of Pterocarpus santalinoides on haemoglobin, packed cell volume and platelets. IOSR-JNHS 2015; 4: 108, 112.
  34. Offor, C. E., Nwankwegu, N. J., Ugwu-Okechukwu, P. C., & Aja, P. M. (2015). The effects of ethanol leaf extract of Pterocarpus santalinoides on liver enzymes of albino rats. American-Eurasian Journal of Agriculture and Environmental Sciences, 15(5), 920-922.
  35. Ezekwe, C. I., Ada, A. C., & Okechukwu, P. U. (2013). Effects of methanol extract of Parkia biglobosa stem bark on the liver and kidney functions of albino rats. Global Journal of Biotechnology & Biochemistry, 8(2), 40-50.
  36. Okechukwu, P. U., Nzubechukwu, E., Ogbansh, M. E., Ezeani, N., Nworie, M. O., & Ezugwu, A. (2015). The Effect of Ethanol Leaf Extract of Jatropha curcas on Chloroform Induced Hepatotoxicity in Albino Rats. Global J Biotech & Biochem, 10, 11-15.
  37. Ezekwe, C. I., Okoro, I. J., Ugwu, P. C., & Ezea, S. C. (2013). The effect of methanol extract of Talinum triangulareon some selected hematological and Kidney parameters of experimental rats. World J Pharm Pharm Sci, 2(6), 4383-4396.
  38. Aja, P. M., Ezeudeh, N. L., Umahi, B. G., Ugwu-Okechukwu, P. C., Enechi, O. C., Nweke, O. L., & Patience, N. O. (2016). Hepato-protective effect of ethanol extract of Pterocarpus santalinoides leaf on carbon tetrachloride (CCl4) induced albino rats. Caribbean Journal of Sciences and Technology, 4(1), 882-895.
  39. Orji, O. U., Ibiam, U. A., Aloke, C., Awoke, J., Aja, P. M., Okechukwu, P. U., … & Nzubechukwu, E. (2016). Biochemical assessment of ethanol leaf extract of cnidoscolusaconitifoliuson liver integrity of albino rat treated with lead. Global J Pharmacol, 10(4), 108-113.
  40. Okechukwu, P. U., Offor, C. E., Ibiam, U. A., Ezugwu, A. L., Uraku, A. J., Igwe, C. N., & Okon, M. B. (2015). The effect of ethanol extract of Jatropha curcas on renal markers of chloroform intoxicated albino wister rats. European Journal of Biological Sciences, 7(1), 21-25.
  41. Ogbanshi, M. E., Agbafor, K. N., Ominyi, C. M., Ugwu Okechukwu, P. C., Nwali, B. U., & Ali, F. U. (2015). Changes in reproductive functions of adult male rats administered water and salt samples from okposi and uburu nigerian salt lakes. American-Eurasian Journal of Toxicological Sciences, 7(2), 55-62.
  42. Ibiam, U. A., Ugwu, O. O., Edwin, N., & Ugwu, O. P. C. (2015). Hepatotoxicity of Rambo and Cork Mosquito-Coil Smoke and the Protective Effects of G. Latifolium Leaf Extract. Journal of Natural Sciences Research, 5(1), 2224-3186.
  43. Alum, E. U., Inya, J. E., Ugwu, O. P., Obeagu, E. I., Aloke, C., Orji, M. O., & Onyema, O. (2023). Ethanolic leaf extract of Datura stramonium attenuates Methotrexate-induced BiochemicalAlterations in Wistar Albino rats. RPS Pharmacy and Pharmacology Reports.
  44. Odom Ruth Obianuju and Okon Michael Ben. Ugwu Okechukwu Paul Chima (2022). The Effect of Ethanol Leaf Extract of Rauwolfia vomitoria on Hepatic Markers of Chloroform Intoxicated Albino Wistar Rats. IAA Journal of Applied Sciences 8 (1) 87-97.
  45. Agu Chibuike Cyprian and Okon Michael Ben Ugwu Okechukwu Paul Chima (2022). The Effect of Methanol Leaf Extract of Rauwolfia vomitoria on Hepatic Markers of Chloroform Intoxicated Albino Wistar Rats. IAA Journal of Applied Sciences. 8(1) 76-86.
  46. Ugwu Okechukwu P.C. and Amasiorah V.I. (2020). The In vitro Antioxidant Potentials of the Crude Ethanol Root Extract and Fractions of Sphenocentrum jollyanum. INOSR APPLIED SCIENCES 6(1125-133.
  47. Okon Michael B. and Onyeke S.C. Ugwu Okechukwu P.C., Onyeneke E.C., Igwenyi, I. O., Aja P. M., Ugwuoke, Kenneth C. (2018). The Effects of Crude Ethanol Root Extract and Fractions of Sphenocentrum jollyanum on Liver and Kidney Function Parameters of StreptozotocinInduced Diabetic Wistar Albino Rats. IAA Journal of Scientific Research 4(1)75-90.

CITE AS: Oke Olusegun Taiwo, Oduntan Sekinat Oluremi, Olasimbo Godswill Ikuejamoye, Abdulrahman Abdulbasit Opeyemi, Olamijuwon Priscilla Busola, Ayara Peter Ayowole and Emmanuel Ifeanyi Obeagu (2024). Assessment of haematological parameter and Liver enzyme among Hepatitis B Infected Blood Donors. IDOSR JOURNAL OF APPLIED SCIENCES 9(1) 15-23.https://doi.org/10.59298/IDOSRJAS/2024/1.3.47198

DOWNLOAD PDF