Peripheral Blood Film Morphology in Patients with Hepatitis B Infection at the Infectious Disease Hospital, Kano

This study examines peripheral blood film morphological abnormalities in patients with chronic hepatitis B virus (HBV) infection at the Infectious Disease Hospital Kano, Kano State, North West Nigeria. Hepatitis B infection induces both direct viral haematological effects and immune-mediated cytopenias, and peripheral blood film examination provides important insights into these changes. A cross-sectional study recruited 100 chronic HBV-positive patients confirmed by HBsAg and HBV DNA assay, and 50 HBsAg-negative controls. Peripheral blood films were prepared and stained with Giemsa and Leishman stains and examined by two independent microscopists. Full blood count parameters were assessed simultaneously. Morphological abnormalities identified included macrocytosis in 34 percent, target cells in 28 percent, hypersegmented neutrophils in 18 percent, and mild poikilocytosis in 21 percent. Thrombocytopenia was present in 42 percent of HBV patients, correlating with the degree of liver fibrosis assessed by clinical staging. Lymphocytosis was observed in 37 percent of patients, reflecting the ongoing antiviral immune response. Patients with cirrhotic complications showed the most diverse morphological abnormalities. Film morphology was not routinely performed in the majority of patients prior to enrolment, suggesting an underutilised diagnostic resource. The study recommends routine peripheral film examination alongside automated blood count in the haematological workup of all HBV-infected patients at the hospital. Keywords: hepatitis B, peripheral blood film, thrombocytopenia, morphological abnormalities, Kano.