Seroepidemiology and clinical features of hepatitis delta among HBsAg carriers: a study from Hepatitis Clinic of Iranian Blood Transfusion Organization

Transfus Med. 2014 Dec;24(6):411-7. doi: 10.1111/tme.12163. Epub 2014 Dec 18.

Abstract

Background: Hepatitis B is a significant health problem and more than 350 million individuals are infected with hepatitis B virus (HBV) globally. About 5% of these individuals are coinfected with hepatitis D virus (HDV). HBV-HDV coinfection increases the rate of fulminant hepatitis, chronic hepatitis and cirrhosis. This study aimed to evaluate the epidemiology of HDV in individuals positive for hepatitis B surface antigen (HBsAg) who were referred to Tehran Blood Transfusion Hepatitis Clinic from 2011 to 2012.

Materials and methods: HBsAg-positive individuals attending this clinic were tested for anti-HDAg antibodies (anti-HDAbs). All samples positive for anti-HDAb were also tested for detection of HDV RNA by reverse transcription-polymerase chain reaction (RT-PCR). A questionnaire consisting of demographic characteristics and potential risk factors for acquisition of HDV was filled for each individual.

Results: Among 1038 individuals, HBsAg was detected in 660 (63.6%) cases following blood donation and in 378 (36.4%) cases following blood testing. In this study, 23 [2.2%, 95% confidence interval (CI) = 1.3-3.2%] patients were HDV-seropositive. In HDV-seropositive patients, 14 (60.9%, 95% CI = 39.1-78.3%) were positive for HDV RNA. HDV-seropositive cases were more likely to have evidence of severe forms of hepatitis than the group of individuals without anti-HDAb (P < 0.01). Familial history of hepatitis D infection was more observed in HDV-seropositive patients than in individuals negative for anti-HDAb (P < 0.01).

Conclusion: The seroprevalence of HDV in HBsAg-positive individuals in this study was about 2% which seems to be lower than the global prevalence of HDV.

Keywords: hepatitis B; hepatitis D; viral load.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Blood Donors
  • Coinfection* / blood
  • Coinfection* / epidemiology
  • Female
  • Hepatitis B Surface Antigens / blood*
  • Hepatitis B* / blood
  • Hepatitis B* / epidemiology
  • Hepatitis D* / blood
  • Hepatitis D* / epidemiology
  • Hepatitis Delta Virus*
  • Hospitals, Special
  • Humans
  • Iran
  • Male
  • Middle Aged
  • RNA, Viral / blood*
  • Seroepidemiologic Studies

Substances

  • Hepatitis B Surface Antigens
  • RNA, Viral