Coinfection of hepatitis B and hepatitis delta virus in Belgium: A multicenter BASL study. Prospective epidemiology and comparison with HBV mono‐infection

Abstract

Epidemiological data on hepatitis delta virus (HDV) infection in Belgium are lacking. A multicenter questionnaire-based registry on HDV infection was collated between March 1, 2008 and February 28, 2009. It consisted of patients coinfected with hepatitis B virus (HBV) and HDV. The data samples were compared to those of a concurrent registry on HBV infection. Prospective data of patients with HBV-HDV coinfection were collected. Active HBV replication is defined as HBeAg positivity or HBV DNA > 2,000 IU/ml. Forty-four patients from 15 centers were registered. A comparison of 29 patients infected with HDV (registered in the concurrent HBV registry) was made against 785 HBV mono-infected patients. The seroprevalence of patients coinfected with HBV and HDV in Belgium is reported to be 3.7% (29/785), consisting solely of the HBV-HDV coinfected patients in the HBV registry. This rises to 5.5% (44/800) if all patients infected with HDV from the two registries combined are included. The patients coinfected with HBV and HDV had higher (P < 0.05) ALT values and more advanced liver disease (Metavir score ≥F2), but had less active HBV replication and lower HBV DNA titers when compared with the patients infected only with HBV. Additionally, the majority of HBV-HDV coinfected patient was male, and 13.6% (6/44) of the patients that were coinfected HBV and HDV were also infected with HCV. In conclusion, this study provided much needed epidemiological data on the current state of HDV infection in Belgium.

Delta hepatitis within the Veterans Affairs medical system in the United States: Prevalence, risk factors, and outcomes

“…The 3.4% seropositive prevalence rate of HDVAb in HBsAg-positive U.S. veterans remains relatively low compared to rates seen in endemic regions such as the Mediterranean basis (overall 14.8% 14 , up to 45.5% in eastern Turkey 15, 16 , 44% in Tunisia 17 ), south Asia (17% in Iran 18 , 16.6% in Pakistan 19 , 8.6% in Saudi Arabia 20 ), Amazon Basin 21 and Mongolia (56–66%) 22 and is similar to rates seen in western Europe. 13, 23–25 Importantly, as testing rates are quite low, it is difficult to draw conclusions about actual HDV prevalence in the US. Further studies with improved testing for high risk populations will need to be performed to characterize prevalence.…”

Molecular epidemiology of hepatitis B and hepatitis delta viruses circulating in the Western Amazon region, North Brazil

“…Even under universal HBV vaccination programs, surveillance in western Amazon should be continued to help delineate improved measures to control these infections and molecular epidemiology studies are important to define the regional pattern of endemicity. The importance of surveillance studies can be highlighted by the recent reports of high rates of HBV and HDV coinfection in developed countries mainly due to the immigration of patients from highly endemic regions and to the increased intravenous drug use [32-34]. The Amazon region attracts a significant number of migrants and tourists from all over the world and should be monitored regarding the possible introduction of different HBV and HDV genotypes that circulate in other countries, as well as their potential impact on clinical outcomes of coinfection regionally.…”

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

“…Compensated liver cirrhosis was present in 21% of HBV–HDV‐coinfected patients and 12% of HBV‐monoinfected cases; also, chronic active hepatitis was detected in 40·6% of patients with HBV–HDV coinfection and in 31% of HBV‐monoinfected individuals. Ho et al (), followed HBV–HDV‐coinfected and HBV‐monoinfected individuals and showed that the HBV–HDV‐coinfected cases had more advanced liver disease (Metavir score ≥ F2). In another study, 188 HBV–HDV‐coinfected patients were evaluated, 82 (43%) patients had chronic hepatitis at histology and 106 cases had a clinical/histological diagnosis of cirrhosis (Niro et al , ).…”