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

Abstract

Background: Co-infection with hepatitis B (HBV) and hepatitis D (HDV) is common among human immunodeficiency virus (HIV) infected individuals in developing countries and it aggressively accelerates progression of liver disease to cirrhosis and other complications. There is scarcity of data on HDV in sub-Saharan Africa .We investigated the sero-prevalence and factors associated with HDV antibody among HIV/HBV co-infected patients attending a large urban HIV clinic in Uganda. Methods: We screened 189 HIV/HBV co-infected individuals for anti-HDV immunoglobulin G (IgG) and performed logistic regression to determine the associated factors. Socio-demographic, clinical data, immunological status, and liver fibrosis (as determined by the Aspartate transaminase to platelet ratio index and transient elastography) were included. Results: Participants were predominately young and of sound immunologic status (median age 40 years, median CD4 440 cells/µl). 98% were on ART regimens containing anti-HBV active medications (95.2% were on TDF/3TC while 4.8% on 3TC containing regimen). Median duration on ART was 36 months . Anti-HDV was detected in 6/198, 3.2% (95% CI 1.14-6.92%), associated with male gender and a duration of more than 5 years since HIV diagnosis. Conclusions:The sero-prevalence of HDV antibodies among the HIV/HBV co-infected patients is low in a Ugandan urban cohort.

Sero-Prevalence and Risk Factors for HDV Infection Among HIV/HBV Co-Infected Patients in Sokoto North Western Nigeria

“…Higher mean ALT levels among Delta virus infected participants compared to non-Delta virus infected participants even though not statistically significant may be a pointer of adverse effect of HDV infection on liver cells and this may result in abnormal ALT levels. On the other hand, mean AST levels was higher among non-HDV infected than in HDV infected HIV/HBV study participants, however it was not statistically significant and this finding is comparable to what Motamedifar et al, (2015) and Katwesigye et al, (2016) documented in similarly related studies. The explanation of this finding in the current study is that, non-Delta virus infected study participants may probably have one or more of other disease conditions such as: myocardial infarction, acute haemolytic anaemia, skeletal muscle disorders and pancreatitis that may also cause AST elevation.…”

“…The current study recorded lower sero-prevalence of HDV infection (10.8 %) among HIV/HBV coinfected study participants compared to a number of studies (Honge et al, 2014; Motamedifar et al, 2015; Coffie et al, 2017). However, the value recorded in the current study was higher compared to other values recorded in some studies across the world including Nigeria (Mendes-Correa et al, 2011; Katwesigye et al, 2016;Ifeorah et al, 2017). Lower value of triple infection of HIV/HBV/HDV obtained in same Northern part of Nigeria is in line with the view of some researchers that global HDV epidemiology is changing (Mumtaz et al, 2005).…”

“…Study participants with tipple infection of HIV/HBV/HDV were observed to have higher mean ALT levels compared to those with HIV/HBV co-infection, though not statistically significant. Similarly, Motamedifar et al, (2015) and Katwesigye et al, (2016) in their studies did not record statistical difference with regards to ALT levels among HIV/HBV co-infected study participants with positive and negative anti HDV. Smaller number of study participants that were positive for anti HDV may probably have contributed to the lack of association.…”

Capacity assessment for provision of quality sexual reproductive health and HIV-integrated services in Karamoja, Uganda

“…SRH care plays a crucial role also in the sexually transmitted diseases, primarily HIV. In fact, it is globally recognized that, in order to decrease HIV transmission, other than ensuring HIV testing, an early treatment and follow up, it is necessary to educate young people, especially in order to prevent new infections 11 – 13 and co-infections 14 – 17 . Moreover, in countries where HIV prevalence has declined, a change in sexual behavior among young people is considered an important contributing factor 18 .…”

Child, reproductive, mental health; infections and NCDs in the African environment

“…The section ends with a rhetorical question: Does exercise alleviate depression related systemic inflammation in chronic obstructive pulmonary disease patients? 24 Infections: Subjects on infections include: sero-prevalence of hepatitis delta antibodies in HIV/ hepatitis B co infected patients 25 ; post-transplant withdrawal of lamivudine and fatal hepatitis flares in kidney transplant recipients, under immunosuppression, with inactive hepatitis B infection. 26 The next paper exlores patient satisfaction with TB care clinical consultations 27 ; while Abbas reports on glyceryl trinitrate as a novel inhibitor of quorum sensing in Pseudomonas aeruginosa 28 .…”