Clinical presentation and genotype of hepatitis delta in Karachi

Moatter, Tariq; Abbas, Zaigham; Shabir, Sabhita; Jafri, Wasim

doi:10.3748/wjg.v13.i18.2604

Cited by 28 publications

(29 citation statements)

References 22 publications

(26 reference statements)

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“…This result is in accordance with previous study on HDV genotypic analysis of Pakistan [18]. The clustering of sequences of some of our isolates may point towards formation of a subgroup within clade I.…”

Section: Discussionsupporting

confidence: 93%

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Phylogenetic analysis of HDV isolates from HBsAg positive patients in Karachi, Pakistan

Perveen

Nasir

Shahid

et al. 2012

Virol J

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BackgroundIn spite of a high occurrence of Hepatitis Delta in the province of Sindh in Pakistan, no genetic study of Hepatitis Delta virus (HDV) isolates from this region was carried out. The aim of this study is to analyze the genetic proximity within local HDV strains, and relationship with other clades of HDV, using phylogenetic analysis.ResultsPhylogenetic analysis of nucleotide sequences of the Hepatitis Delta Antigen (HDAg) R0 region obtained in this study, showed considerable diversity among the local strains with a potential subgroup formation within clade I. The multiple sequence alignment of predicted amino acids within clade I showed many uncommon amino acid substitutions within some conserved regions that are crucial for replication and assembly of HDV.ConclusionsThe studied strains showed a range of genetic diversity within HDV clade I. There is clustering of sequences into more than one group, along with formation of potential subgroup within clade I. Clustering shows the genetic closeness of strains and indicates a common origin of spread of HDV infection. Further phylogeny-based studies may provide more information about subgroup formation within clade I and may be used as an effective tool in checking and/or preventing the spread of hepatitis D virus infection in this region.

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Section: Discussionsupporting

confidence: 93%

“…The second round nested fragment was amplified under the same conditions described for the first round of amplification [17,18]. …”

Section: Methodsmentioning

confidence: 99%

Phylogenetic analysis of HDV isolates from HBsAg positive patients in Karachi, Pakistan

Perveen

Nasir

Shahid

et al. 2012

Virol J

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“…Interferon based therapy is known to induce HBsAg seroconversion and it is usually associated with low pretreatment HBsAg levels [16] . We did not check for genotypes of HBV and HDV for this study as it is already known that the genotype of hepatitis D is 1 [17] and of hepatitis B is D in our region [18] . We followed our patients for six months post treatment.…”

Section: Discussionmentioning

confidence: 99%

Co-treatment with pegylated interferon alfa-2a and entecavir for hepatitis D: A randomized trial

Abbas

Memon

Umer

et al. 2016

WJH

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AIM:To investigate the efficacy of pegylated interferon alfa (PEG-IFNα) therapy with and without entecavir in patients with chronic hepatitis D. METHODS:Forty hepatitis D virus (HDV) RNA positive patients were randomized to receive either PEG-IFNα-2a 180 µg weekly in combination with entecavir 0.5 mg daily (n = 21) or PEG-IFNα alone (n =19). Patients who failed to show 2 log reduction in HDV RNA level at 24 wk of treatment, or had detectable HDV RNA at 48 wk of therapy were considered as treatment failure. Treatment was continued for 72 wk in the rest of the patients. All the patients were followed for 24 wk post treatment. Intention to treat analysis was performed. RESULTS:The mean age of the patients was 26.7 ± 6.8 years, 31 were male. Two log reduction in HDV RNA levels at 24 wk of therapy was achieved in 9 (43%) patients receiving combination therapy and 12 (63%) patients receiving PEG-IFNα alone (P = 0.199). Decline in hepatitis B surface antigen (HBsAg) levels was insignificant. At the end of treatment, HDV RNA was negative in 8 patients (38%) receiving combination Co-treatment with pegylated interferon alfa-2a and entecavir for hepatitis D: a randomized trial Randomized Clinical Trial ORIGINAL ARTICLEtherapy and 10 patients (53%) receiving PEG-IFNα-2a alone. Virological response persisted in 7 (33%) and 8 (42%) patients, respectively at the end of the 24 wk follow-up period. One responder patient in the combination arm lost HBsAg and became hepatitis B surface antibody positive. Six out of 14 baseline hepatitis B e antigen reactive patients seroconverted and four of these seroconverted patients had persistent HDV RNA clearance. CONCLUSION:Administration of PEG-IFNα-2a with or without entecavir, resulted in persistent HDV RNA clearance in 37% of patients. The addition of entecavir did not improve the overall response.

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“…In Larkana, Pakistan (Shaikh et al 2011) and Pubjab, India (Zaidi et al 2010), 23.6% and 88.8%, respectively, of the HBsAg carriers with liver disease were found to have anti-HD. In HBsAg patients in Karachi, Pakistan, the antibody prevalence has varied from 35% to 59% (Moatter et al 2007;Baig et al 2009). Throughout Iran, anti-HD prevalence of 5.7% -12.7% were found from 2002 through 2009 in patients with chronic HBsAg liver disease (Rizzetto and Ciancio 2012).…”

Section: Epidemiological Changes In the Last Two Decades In Europementioning

confidence: 99%

Hepatitis D Virus: Introduction and Epidemiology

Rizzetto

2015

Cold Spring Harb Perspect Med

141

123

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Hepatitis D is caused by the hepatitis D virus (HDV), a unique RNA pathogen that requires the hepatitis B surface antigen (HBsAg) to infect. Hepatitis D is transmitted by the parenteral route. The main susceptible group is patients with chronic HBsAg infection who become superinfected with the virus. Hepatitis D occurs throughout the globe, but control of hepatitis B virus (HBV) in the last two decades has consistently diminished the circulation of HDV in industrialized countries. However, hepatitis D remains a medical issue for injecting drug users (IDUs), as well as immigrants from endemic HDV areas, who are reintroducing the infection in Europe.

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Clinical presentation and genotype of hepatitis delta in Karachi

Abstract: HDV may infect at any age, usually young adult males. Genotype I is prevalent. With time some of the patients become HDV RNA negative or asymptomatic carrier. Most of the patients have suppressed HBV DNA replication. Significant numbers of patients have cirrhosis.

Cited by 28 publications

References 22 publications

Phylogenetic analysis of HDV isolates from HBsAg positive patients in Karachi, Pakistan

Phylogenetic analysis of HDV isolates from HBsAg positive patients in Karachi, Pakistan

Co-treatment with pegylated interferon alfa-2a and entecavir for hepatitis D: A randomized trial

Hepatitis D Virus: Introduction and Epidemiology

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