High endemicity of Hepatitis B infection and hidden liver injury in a community in Nasarawa State, North-Central Nigeria

Hepatitis B virus (HBV) infection remains a major public health challenge in Nigeria, contributing significantly to the burden of chronic liver disease. Despite the endemic nature of HBV in the country, community-level data on its prevalence and biochemical correlates are limited in Nasarawa State. This study assessed the prevalence, viral load distribution, and biochemical profiles of HBV infection among residents of selected communities in the state. A community-based retrospective cross-sectional analytical design study was conducted among 2,535 participants selected from eight settlements in Nasarawa State. Venous blood samples were collected and screened for Hepatitis B surface antigen (HBsAg) using immunochromatographic and ELISA methods. HBV viral load was quantified among HBsAg-positive individuals using real-time polymerase chain reaction. Biochemical parameters including alanine transaminase (ALT), aspartate transaminase (AST), platelet count, ALT–AST ratio, and AST–Platelet Ratio Index (APRI) were evaluated using standard laboratory protocols. Data were analyzed using IBM SPSS version 26, with descriptive and comparative statistics applied. Of the 2,251 individuals tested for HBsAg, 703 (31.2%) were positive, indicating high HBV endemicity. The mean age of participants was 35.0 ± 14.8 years, and females accounted for 1,389 (54.8%). Among HBsAg-positive individuals with viral load results, 434 (61.7%) had low viral load (< 2,000 IU/mL), while 269 (38.3%) had high viral load (≥ 2,000 IU/mL). Elevated ALT and AST levels were observed in 236 (33.5%) and 457 (65.0%) participants, respectively. The mean platelet count was 191 × 10⁹/L, with 72 (10.3%) showing severe thrombocytopenia. The mean APRI score was 1.0 ± 1.1, suggesting varying degrees of hepatic fibrosis. This study demonstrates a high prevalence of HBV infection in Nasarawa State, predominantly affecting young and middle-aged adults. Elevated liver enzymes and altered platelet indices indicate ongoing hepatocellular injury among infected individuals. Strengthening community-based screening, vaccination, and linkage to care is essential to reduce HBV transmission and progression to chronic liver disease.