Characterization of Hepatitis Delta Virus in Sub-Saharan Africa

Abstract

Hepatitis D virus (HDV) is a satellite of hepatitis B virus (HBV), and infection with this virus aggravates acute and chronic liver disease. While HBV seroprevalence is very high across sub-Saharan Africa, much less is known about HDV in the region. In this study, almost 2,300 blood serum samples from Burkina Faso (n ‫؍‬ 1,131), Nigeria (n ‫؍‬ 974), Chad (n ‫؍‬ 50), and the Central African Republic (n ‫؍‬ 118) were screened for HBV and HDV. Among 743 HBsAg-positive serum samples, 74 were positive for HDV antibodies and/or HDV RNA, with considerable differences in prevalence, ranging from <2% (pregnant women from Burkina Faso) to 50% (liver patients from Central African Republic). HDV seems to be much more common in chronic liver disease patients in the Central African Republic (CAR) than in similar cohorts in Nigeria. In a large nested mother-child cohort in Burkina Faso, the prevalence of HDV antibodies was 10 times higher in the children than in their mothers, despite similar HBsAg prevalences, excluding vertical transmission as an important route of infection. The genotyping of 16 full-length and 8 partial HDV strains revealed clade 1 (17/24) in three of the four countries, while clades 5 (5/24) and 6 (2/24) were, at least in this study, confined to Central Nigeria. On the amino acid level, almost all our clade 1 strains exhibited a serine at position 202 in the hepatitis D antigen, supporting the hypothesis of an ancient African HDV-1 subgroup. Further studies are required to understand the public health significance of the highly varied HDV prevalences in different cohorts and countries in sub-Saharan Africa.

Low sero-prevalence of hepatitis delta antibodies in HIV/ hepatitis B co-infected patients attending an urban HIV clinic in Uganda

“…These results are comparable to some other studies in sub-Saharan Africa (SSA) done in similar settings [14][15][16] but quite different in other selected sub-populations including those with chronic liver disease in West Africa where a high anti-HDV prevalence ranging from 12.2 to 81.7% was documented 17 . Also other studies in Africa have showed varying prevalence rates of HDV ranging from 0-50% in different countries [18][19][20] .…”

Epidemiology and phylogenetic analysis of hepatitis D virus infection in Australia

“…5,10 Phylogenetic analysis was performed in this study to evaluate further relatedness of the strains circulating in Australia. 33 In contrast, the genotype 1 African strains from Australian patients tended to originate from East Africa (Fig. 3) were born in either Liberia or Sierra Leone, located on the west coast of Africa.…”

Hepatitis delta virus: From biological and medical aspects to current and investigational therapeutic options

“…In Mauritania a prevalence rate of 33.1% among HBsAg positive patients was recently reported, and HDV was associated with more aggressive disease than HBV infection alone (122). Other studies show wide differences in sero-prevalence in HBsAg positive liver patients, ranging from 1.3% in a Nigerian center, to 50% in Central African Republic and 66% in Gabon (123,124). However it should be kept in mind that data on anti-HDV seroprevalence are lacking from several African areas.…”