Clinical Impact and Frequency of Hepatitis D Virus Infection in HBsAg Positive Patients in a Southern Province of Iran (Kerman)

Abstract

Background and Aims: Hepatitis D virus (HDV) can infect human population either as a superinfection or concurrent hepatitis B virus (HBV) infection. It is expected that presence of HDV infection is more prevalent in endemic HBV areas. Overall 5% of Iranian general populations are chronic HBV carriers. The aim of this study was to determine the seroprevalence of HDV and its clinical impact in a local area of southern Iran (Kerman province). Methods: The study carried out during 2006-2007 on all hepatitis B surface antigens (HBsAg) positive subjects who referred to the main referral hospital (Afzalipour Academic Health Center) and subspecialty GI offices in the city of Kerman. The study included just stable chronic hepatitis B and inactive HBV carriers around the province. High risk group subjects and other concurrent hepatitis viral infections were excluded. Results: One hundred and ninety six patients were enrolled in the study. They consist of 143 (73%) men, 53 (27%) women, with a mean age of 39.2 ± 7.1 (range 20-60) years. Twentyone subjects (10.7%) were positive for anti HDV antibody (Ab). Male to female ratio was 6/1 in this group. All of the HDV positive cases acquired the infection as a super-infection. Elevated aminotransferases (ALT-AST) was documented in 81% of HDV positive cases and in 41% of HDV negative subjects (p=0.001). Conclusion: HDV investigation is recommended in HBV infected patients, particularly those with elevated liver enzymes in a relatively high prevalent area as in Iran.

Prevalence of Hepatitis D in the Eastern Mediterranean Region: Systematic Review and Meta Analysis

“…Thus, the 62 (5, 87-143) studies to be included were identified assessing the HDV prevalence in the EMRO countries and fulfilling inclusion criteria. Out of these,19 studies (95-113) were in Iran, nine studies (129-137) in Saudi Arabia, seven studies (5, 119-124) in Pakistan, six studies (89-94) in Egypt, four studies (138-141) in Tunisia and Somalia (125-128) and two studies (142, 143) in Yemen. There was one study of other countries which consisted of: Afghanistan (87), Djibouti (88), Jordan (114), Kuwait (115), Lebanon (116), Morocco (117), and Oman (118).…”

“…According to the quality assessment score, ten articles were categorized in the good quality group (5, 29, 91, 97, 99, 102, 109, 111, 113, 114). In this group, HDV prevalence was 16.25%, 16.60%, 44.32% among asymptomatic HBsAg positive carriers, chronic hepatitis patients and cirrhotic/HCC patients, respectively.…”

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

“…The HDV prevalence among HBV‐infected individuals which were diagnosed through routes other than blood donation was between 2·9 and 17·0% in different provinces of Iran (Fig. b) (Alavian et al , ; Roshandel et al , ; Taghavi et al , ; Hajiani et al , ; Zahedi et al , ; Ataei et al , ; Bakhshipour et al , ). In a meta‐analysis (Amini et al , ), the total HDV prevalence in HBsAg‐positive individuals was reported to be 6·61% in Iran.…”

“…(a) Prevalence of HDV among Iranian blood donors who were found to be HBsAg ‐positive in different provinces including East Azerbaijan (Jedary Seifi & Sabouri Ghannad, ), Mazandaran (Hassanjani Roshan et al, ), Tehran (Karimi et al, ), Charmahal‐va‐Bakhtiari (Doosti et al, ) and Fars (Kasraian et al, ). (b) Prevalence of HDV among HBV ‐infected patients which were diagnosed through routes other than blood donation in different provinces including Golestan (Roshandel et al, ), Tehran (Alavian et al, ), Isfahan (Ataei et al, ), Kerman (Zahedi et al, ), Khuzestan (Hajiani et al, ), Fars (Taghavi et al, ) and Sistan‐va‐Balouchestan (Bakhshipour et al, ).…”

Evidence of Hepatitis D Virus Infection in HBsAg Positive Subjects of Mashhad, North-East of Iran

“…In Golestan province, the prevalence was reported to be 5.8% ( 12 ). One study even noted a prevalence of 10.7% in Kerman ( 13 ), which is among one of the highest prevalence rates in Iran. In Tehran, capital of Iran, Rezvan et al ( 14 ) noted anti-HDV Ab in 2.4% of HBsAg positive blood donors.…”