Absence of hepatitis delta infection in a large rural HIV cohort in Tanzania

Winter, Annja; Letang, Emílio; Kalinjuma, Aneth Vedastus; Kimera, Namvua; Ntamatungiro, Alex J; Glass, Tracy R.; Moradpour, Darius; Sahli, Roland; Gal, Frédéric Le; Furrer, Hansjakob; Wandeler, Gilles

doi:10.1016/j.ijid.2016.03.011

Cited by 19 publications

(23 citation statements)

References 7 publications

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“…Similarly, the low proportion with HBV/HCV co-infection in our study is probably a reflection of the overall low prevalence of HCV in Ethiopia [32]. The presence of anti-HDV antibodies in our study was also relatively low, which is in line with a previous study from East Africa; however, available data from the region is scarce [33].…”

Section: Discussionsupporting

confidence: 88%

Early Experiences from One of the First Treatment Programs for Chronic Hepatitis B in Sub-Saharan Africa

Aberra¹,

Desalegn²,

Berhe³

et al. 2016

Journal of Hepatology

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Background: Treatment for chronic hepatitis B (CHB) is virtually absent in sub-Saharan Africa. Here we present early experiences from a pilot program for treatment of CHB in Ethiopia. Methods: Adults (≥18 years) with CHB were included in a cohort study at St. Paul's Hospital Millennium Medical College, Addis Ababa, from February 2015. The baseline assessment included liver function tests, viral markers and transient elastography (Fibroscan 402, Echosense, France). Logistic regression models were used to identify predictors of fibrosis. Tenofovir disoproxil fumarate (TDF) was initiated based on the European Association for the Study of the Liver (EASL) criteria, with some modifications. The initial 300 patients underwent a more comprehensive evaluation and are presented here. Results: One-hundred-and-thirty-eight patients (46.0%) were women and median age was 30 years (interquartile range 26-40). Co-infections were rare: four patients (1.3%) were anti-HCV positive, 11 (3.7%) were anti-HDV positive, whereas 5 (1.7%) had HIV-infection. The majority were hepatitis B e-antigen (HBeAg) negative (n = 262; 90.7%) and had a normal (≤40 U/L) alanine aminotransferase (ALT) (n = 245; 83.1%). Of 268 patients with a valid Fibroscan result, 79 (29.5%) had significant fibrosis (>7.9 kPa). Independent predictors of fibrosis were male sex, age > 35 years and viral load >20,000 IU/ml. In total, 74 patients (24.7%) started TDF therapy, of whom 46 (62.2%) had cirrhosis. Conclusions: The majority were HBeAg negative and had normal ALT. However, one quarter of the patients were in need of antiviral treatment, underscoring the need to scale up CHB treatment on the African continent. Trial registration: NCT02344498 (ClinicalTrials.gov identifier). Registered 16 January 2015.

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Section: Discussionsupporting

confidence: 88%

Early Experiences from One of the First Treatment Programs for Chronic Hepatitis B in Sub-Saharan Africa

Aberra¹,

Desalegn²,

Berhe³

et al. 2016

Journal of Hepatology

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“…As false-positive HDV screening results seem to be frequent in the setting of HIV-infection 19 , we performed a confirmatory serology in all patients with a negative HDV RNA in order to strengthen our HDV prevalence estimate. In our study, 14% of positive HDV screening tests were false-positive.…”

Section: Discussionmentioning

confidence: 99%

Hepatitis delta-associated mortality in HIV/HBV-coinfected patients

Béguelin

Moradpour

Sahli

et al. 2017

Journal of Hepatology

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107

119

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“…Large geographical differences in HDV prevalence have also been observed in sub-Saharan Africa. Prevalence rates of 15.6% in Gabon (44), 17.6% in Cameroon (45), and 31.0% in northern Kenya (46) have been reported, whereas no patients tested positive for HDV antibodies in Burundi (personal data), Tanzania, or Mozambique (19). However, as most patients in this study were from the northern part of the country, more extensive epidemiological studies are needed to verify this geographic distribution and assess the extent and the characteristics of HDV infection in the DRC.…”

Section: Discussionmentioning

confidence: 99%

“…Sub-Saharan Africa has some of the highest hepatitis prevalence rates in the world, ranging from 3 to 20% for the HBV surface antigen (17) and from 1 to 7% for HCV (18) in the general population. Similarly, HDV prevalence estimates have revealed large disparities among countries in which carriers of the HBV surface antigen (HBsAg) reside, ranging from 0% in Mozambique to 70.6% in an urban area in Gabon (19, 20). …”

Section: Introductionmentioning

confidence: 99%

High Prevalence and Diversity of Hepatitis Viruses in Suspected Cases of Yellow Fever in the Democratic Republic of Congo

et al. 2017

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The majority of patients with acute febrile jaundice (>95%) identified through a yellow fever surveillance program in the Democratic Republic of Congo (DRC) test negative for antibodies against yellow fever virus. However, no etiological investigation has ever been carried out on these patients. Here, we tested for hepatitis A (HAV), hepatitis B (HBV), hepatitis C (HCV), hepatitis D (HDV), and hepatitis E (HEV) viruses, all of which can cause acute febrile jaundice, in patients included in the yellow fever surveillance program in the DRC. On a total of 498 serum samples collected from suspected cases of yellow fever from January 2003 to January 2012, enzyme-linked immunosorbent assay (ELISA) techniques were used to screen for antibodies against HAV (IgM) and HEV (IgM) and for antigens and antibodies against HBV (HBsAg and anti-hepatitis B core protein [HBc] IgM, respectively), HCV, and HDV. Viral loads and genotypes were determined for HBV and HVD. Viral hepatitis serological markers were diagnosed in 218 (43.7%) patients. The seroprevalences were 16.7% for HAV, 24.6% for HBV, 2.3% for HCV, and 10.4% for HEV, and 26.1% of HBV-positive patients were also infected with HDV. Median viral loads were 4.19 × 105 IU/ml for HBV (range, 769 to 9.82 × 109 IU/ml) and 1.4 × 106 IU/ml for HDV (range, 3.1 × 102 to 2.9 × 108 IU/ml). Genotypes A, E, and D of HBV and genotype 1 of HDV were detected. These high hepatitis prevalence rates highlight the necessity to include screening for hepatitis viruses in the yellow fever surveillance program in the DRC.

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Absence of hepatitis delta infection in a large rural HIV cohort in Tanzania

Abstract: No confirmed case of HDV infection was found among over 200 HIV/HBV co-infected patients in Tanzania. As false-positive serology results are common, screening results should be confirmed with a second test.

Cited by 19 publications

References 7 publications

Early Experiences from One of the First Treatment Programs for Chronic Hepatitis B in Sub-Saharan Africa

Early Experiences from One of the First Treatment Programs for Chronic Hepatitis B in Sub-Saharan Africa

Hepatitis delta-associated mortality in HIV/HBV-coinfected patients

High Prevalence and Diversity of Hepatitis Viruses in Suspected Cases of Yellow Fever in the Democratic Republic of Congo

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