Hepatitis E virus (HEV) is an emerging cause of acute viral hepatitis, particularly in regions with poor sanitation.

This study assessed the seroprevalence of HEV among patients attending the Federal Medical Centre (FMC),

were HEV-negative, suggesting low-level circulation of the virus in this population. Conclusion: The study

found a moderate HEV seroprevalence (6%) among patients at FMC, Mubi. These findings highlight the need

for improved hygiene practices and routine screening for HEV, especially in healthcare settings. Further research

is recommended to better understand HEV epidemiology in Nigeria.

Keywords: Hepatitis E virus, Seroprevalence, Federal Medical Centre Mubi, Viral hepatitis, Public health,

Nigeria.

Hepatitis E virus (HEV) has emerged as a threat to public health, with an estimated number of 70,000 deaths

from genotypes 1 and 2 globally. HEV is a quasi-enveloped, single-stranded, positive-sense RNA virus with a

genome size between 6.4 and 7.2 kb. Classified into the Hepeviridae family Orthohepevirus A, HEV has eight

during pregnancy favor the preservation of the foetus in the maternal environment by the suppression of T

lymphocyte-induced immunity, thus rendering the pregnant woman more vulnerable to contract viral infections

like the HEV, (Navaneethan et al., 2008). HEV infection during the third trimester of pregnancy is associated

to a more severe infection that could lead to hepatic failure and possibly maternal death. Clinical features of

hepatitis E are indistinguishable from acute hepatitis caused by other hepatotropic viruses. The incubation

period ranges from 15–60 days, with a mean of 40 days. HEV-infected persons exhibit a wide clinical spectrum,

ranging from asymptomatic infection through acute icteric hepatitis to fulminant hepatitis. The ratio of

symptomatic to asymptomatic infection has not been reliably determined, and may vary with viral genotype

and epidemiologic setting. Acute hepatitis E usually manifests with icterus, malaise, anorexia, fever,

hepatomegaly, and occasionally pruritus. Studies in non-human primates have shown a relationship between

HEV RNA in clinical samples. Past HEV infection is characterized by specific IgG antibodies against ORF2,

which may confer protection against reinfection; however, the protective titer and the duration of their

persistence are uncertain. Certain population sub-groups are at a higher risk for severe disease following HEV

infection. These include pregnant women, persons with pre-existing liver disease and persons with

immunosuppression, (Kumar, 2022).

During HEV epidemics, fulminant hepatitis occurs with a disproportionately high rate among pregnant women,

Treatment for acute hepatitis E is generally supportive. Chronic hepatitis E in solid organ transplant (SOT)

recipients on immunosuppressive treatment has been successfully treated by withdrawal or reduction of

immunosuppressive drugs, administration of ribavirin, administration of interferon or a combination of these

measures, (Kamar, 2008). Surveillance for hepatitis E disease is very limited and information on disease

serological tests to distinguish between genotypes, and lack of data for reliable mathematical modelling to

determine disease burden from seroprevalence. Furthermore, the majority of seroprevalence studies do not

involve a representative sample of any population making it difficult to infer prevalence and trends to the

population, Poor laboratory assay performance is the major challenge in interpreting seroprevalence study

results. Many studies have shown poor concordance between commercial IgG HEV assays; some reports

showed significant batch to batch variability of IgG anti HEV assays, (Abravenel, 2020). The lack of a gold

standard test to determine the performance of IgG assays is another challenge. Recent studies comparing the

diagnostic accuracy of assays commonly used in Europe and the US for the detection of antibodies against HEV

have yielded a significant discrepancy in performance, (Abravanel, 2020). The protective efficacy and the long-

term persistence of IgG antibodies against HEV following natural infection has not been clearly determined.

vaccine efficacy. In spite of all these challenges, seroprevalence data provides a general picture as to whether

HEV infection is endemic in a country, if population has a disproportionately high rate of infection (e.g., persons

with animal contact), and for estimation of population level susceptibility to HEV infection. The result obtained

could be due to the fact that during an HEV infection IgM type antibodies are synthesized 1 to 4 weeks before

clinical manifestations and disappear 8 to 12 weeks after infection. Anti-HEV IgM is the serologic marker of

choice for diagnosis of acute HEV infection. On the other hand, anti-HEV IgG antibodies usually persist for

many years after infection. HEV-genotypes 1 and 2 (HEV-1 and -2) are transmitted via the fecal-oral route and

exclusively infect humans. Infections with HEV-1 can be more severe in HIV, where case fatality rates up to

25% have been reported. (https://www.who.int/immunization/sage/meetings/2023/o (2020). Also, certain

population groups like immunosuppressed persons and individuals with pre-existing liver disease are more

common cause of liver failure, accounting for 20% of cases in regions endemic for HEV. Furthermore, in some

Adamawa State, Nigeria. In addition, Hepatitis E virus (HEV) is an emerging infectious agent More than 20

million cases of HEV infection occur that causes acute viral hepatitis worldwide. Annually all over the world,

with about 70,000 deaths. HEV is the leading cause of enteric ally-transmitted viral hepatitis. Hepatitis E as

sporadic disease or outbreaks have occurred in at least sixty-three countries; about half of these countries have

reported large outbreaks.

The main aim of this study was to determine the Seroprevalence of Hepatitis E virus among patients attending

Federal Medical Centre, Mubi, Adamawa state, Nigeria.

The objectives of this study are to:

Federal Medical Centre, Mubi is located in the heart of Mubi town, in the Mubi North Local Government Area

the town center. Mubi is situated in the northern part of Adamawa State, Nigeria. The town lies between latitudes

10°15'N and 10°20'N, and longitudes 13°15'E and 13°20'E. Mubi has a semi-arid climate with a rainy season

that lasts from May to October. The average annual rainfall is around 800 mm, with a mean temperature of 28°C.

The vegetation in Mubi is mainly savanna grassland with scattered trees, including acacia and bauna. Mubi is

situated in a valley surrounded by hills.

The town has a gentle slope, with an average elevation of 500 meters above sea level. The demographic

characteristics of Mubi include: Population: As of 2016, the estimated population of Mubi North Local

provides outpatient services, including general consultations, laboratory tests, and pharmacy services. The

hospital has an inpatient ward, providing care for patients requiring hospitalization. The hospital has a maternity

ward, providing antenatal, delivery, and postnatal care. The hospital has a laboratory, providing a range of

diagnostic tests, including blood tests, urine tests, and stool tests.

The study population for this research included the patients attended Federal Medical Centre, Mubi.

Approximately 4ml of blood was aseptically collected from each volunteer using a sterile syringe and needle

from a prominent vein situated at the antecubital fossa of each individual and placed in 5ml plain bottle.

= 0.2499

The age distribution of the study population shows the highest number of participants (30%) were within the

Out of the 100 participants, 5 tested positive for Hepatitis E Virus (HEV). These HEV-positive cases were

distributed across the younger to middle-age groups as follows:

No HEV-positive cases were recorded in participants aged 50 years and above.

These findings suggest that HEV infection was more commonly observed in individuals under the age of

50, with a notable clustering between the ages of 38 to 44 years. However, due to the small number of positive

cases (n = 5), statistical inference about age-specific risk is limited.

Since p > 0.05, we fail to reject the null hypothesis, indicating that:

There is no statistically significant association between gender and HEV seropositivity in this study

population.

Hepatitis E virus infection recently has been described as an emerging infection among patients with

immunosuppressing conditions of such human immunodeficiency infection, (kaba et al., 2022). In this study,

out of 100 participants we found a moderate (5%) of HEV among positive individuals attending FMC, Mubi.

Although this rate is higher than the previously reported among similar populations in the industrialized

among some population groups HEV endemic areas of Africa and Asia. This study agreed with finding of

Omolade et al., (2018) who reported the prevalence of HEV infection found in this study is lower than the

previously reported rate of 44% among Health workers in Nigeria. Although the reason for this difference is not

also been reported, (kaba et al., 2022). This present study, demonstrated that majority 94(94%) of the study

hepevirus of the family Hepeviridae. The virus is transmitted from person to person feco-orally, hence its

transmission is highly associated with poor hygiene or sanitation, (Vasickova et al., 2007). While some studies

have shown that HEV infected individuals are not at higher risk of acquiring infection than the general

population, (Robson et al., 2020), they are at higher risk of developing chronic HEV infection, The

seroprevalence of HEV infection in the general population in Nigeria has not been determined, however, the

results of this study suggest the need to test for HEV infection in individuals for the early diagnosis and proper

management since HEV is known to be fulminant in the presence of underlying liver diseases that are common

among infected persons, according to Aggarwal and Gandhi, (2020).

The results of this study suggest the need to test for HEV infection in individuals for the early diagnosis and

proper management since HEV is known to be fulminant in the presence of underlying liver disease that is

common among HEV infected persons. In addition, the use of ART may reduce the incidence of HEV infection.