Molecular epidemiology of hepatitis delta and hepatitis B viruses circulating in two major provinces (East and North-West) of Pakistan

Aftab, Mahwish; Amin, Irum; Idrees, Muhammad; Ali, Amjad; Rafique, Shazia; Naz, Shagufta

doi:10.1016/j.meegid.2018.06.013

Cited by 15 publications

(12 citation statements)

References 21 publications

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“…the present study showed that the HDV infection prevalence is lower in Iran than in its neighboring countries. The HDV infection rate was reported to be as high as 14.66% among 1890 HBV patients from east and northwest of Pakistan (22). Likewise, the prevalence rates of the infection in Turkey (9.6%) and Iraq (6.6%) were higher than the prevalence reported in the present study (23,24).…”

Section: Discussioncontrasting

confidence: 63%

Sero-Prevalence of Hepatitis D Virus Infection Among Hepatitis B Surface Antigen Positive Patients in Mashhad, Northeastern Iran

et al. 2019

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Background: Transmission and persistence of Hepatitis Delta Virus (HDV) depends on presence of the hepatitis B surface antigen (HBsAg) envelope proteins. The prevalence of HDV infection has not been reported previously among HBsAg-positive patients in Mashhad, Iran. Objectives: To evaluate HDV seroprevalence among individuals with HBsAg seropositivity in Mashhad, Northeastern Iran. Methods: This cross-sectional was performed in Central Diagnostic Lab of Academic Center for Education, Culture, and Research (ACECR), Mashhad, Iran. Based on database of the lab, 606 HBsAg positive patients were tested for anti-HDV antibodies using the enzyme-linked immunosorbent assay (ELISA) during 2016-2017. Chi-square or Fisher's exact tests and T-test were used to analyze the data by SPSS software at a significance level of 5%. Results: Among 606 HBsAg positive patients including 335 (55.3%) males and 271 (44.7%) females with a mean age of 43.6 ± 14.8 years old, 35 cases (5.8%) were found to be anti-HDV positive. HDV infection was more prevalent among males (6.9%), older patients (P = 0.008), and individuals with elevated ALT (P = 0.034) and AST serum levels (P = 0.021). Regarding HBV viral load, there was no significant difference between HBV/HDV co-infected and HBV mono-infected patients (P = 0.07). Conclusions: Prevalence of HDV infection was found to be relatively high among HBsAg-positive cases in this region. Therefore, it is suggested to assess HDV antibodies among HBsAg-positive patients, especially those with higher serum levels of transaminases.

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Section: Discussioncontrasting

confidence: 63%

Sero-Prevalence of Hepatitis D Virus Infection Among Hepatitis B Surface Antigen Positive Patients in Mashhad, Northeastern Iran

et al. 2019

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“…Hepatitis D, driven by genotype 1 HDV is a growing burden in Pakistan [12,13]. Various studies from across the country have shown a prevalence of 14-18% of HDV infection in HBsAg positive individuals [2,14,15]. However, the prevalence of anti-HDV antibodies is much higher; up to 37-38% in HBsAg positive patients with chronic liver disease, visiting liver clinics or hospitals for treatment, seem to harbour the HDV virus [16,17].…”

Section: Discussionmentioning

confidence: 99%

“…Although it is accepted that the HDV causes a more severe infection at a younger age than HBV monoinfection, studies have not adequately tracked disease progression in the younger population. Indeed, while many studies done in Pakistan have shown that many hepatitis D patients are young adults (21-40 years) [15,22], none have studied the disease exclusively in the 18-25 year demographic.…”

Section: Discussionmentioning

confidence: 99%

The Severity of Hepatitis D in Young Adults of Age 18-25 Years

Abbas

Qadeer

Mandviwalla

et al. 2020

Cureus

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Background Current literature on the prevalence and characteristics of hepatitis D virus (HDV) infection in young adults is limited. This study aims to determine the disease characteristics and severity in young adults. Methods The case records of HDV RNA positive patients of age 18-25 years were analyzed. Results Out of 119 patients, 105 (88%) patients were male. HBV-DNA was detectable in 83 (70%). Hepatitis B eantigen (HBeAg) was non-reactive in 99 (83%). Cirrhosis was identified in 45 (37.8%) individuals; nine (7.5%) were classified as Child class B or Child class C. Twenty-four (20.2%) had a Model For End-Stage Liver Disease (MELD) score of ≥10, out of these 16 had a score of 15 or more. The risk of decompensation was calculated according to the Baseline-event-anticipation (BEA) score; eight (6.7%) patients were at BEA-A (mild risk), 105 (88.2%) were at BEA-B (moderate risk), and six (5.0%) were at BEA-C (severe risk). Notable findings in patients with cirrhosis included splenomegaly, low total leucocyte counts, low platelets, high bilirubin, elevated aspartate aminotransferase, gamma-glutamyl transferase and international normalization ratio, low albumin, high AST to Platelet Ratio Index (APRI), and high BEA score. The splenic size, platelet count, and albumin levels were independently associated with cirrhosis (p < 0.001, <0.001, and 0.003). A model using a combination of platelet count, albumin, and spleen size was developed to accurately predict cirrhosis in this cohort. It had an area under the receiver operating characteristics (AUROC) of 0.935. Conclusions HDV-infected young adults, age 18-25 years, were at moderate to severe risk of disease progression. About one-third of patients had already developed cirrhosis indicating the aggressive nature of the disease.

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“…Researchers have reported varying prevalence rates for HBV across Pakistan [7]; the World Health Organization (WHO) has listed Pakistan as an intermediate endemicity region with an HBV prevalence of 3-5% [6,8]. The estimated disease burden of HBV in Pakistan is between 8-12 million cases [9,10]. However, these numbers may not be accurate as data and records from secondary care setups, rural clinics, far-off dispensaries (usually suburban), and small private clinics and hospitals are all but missing.…”

Section: Introductionmentioning

confidence: 99%

Demographics, Biochemical Characteristics, and Phases of Chronic Hepatitis B Virus Infection: Retrospective Analysis From a Secondary Care Setup

Khan¹,

Haider²,

Nusrat³

et al. 2021

Cureus

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IntroductionHepatitis B virus (HBV) is the leading cause of cirrhosis in the developing world. Despite the development of effective vaccine(s) and direct-acting antivirals (DAAs) such as tenofovir and entecavir, the eradication of chronic HBV remains a distant dream in endemic regions. Factors such as treatment naivety, longer duration of disease, late diagnosis, family history of liver disorders and hepatocellular carcinoma, fatty liver disease, multiple comorbidities, alcoholism, use of tobacco products, noncompliance to drugs, and loss to follow-up all contribute to disease progression and development of complications.In order to promote a better understanding of the treatment initiation, duration, and eventual outcomes, the European Association for the Study of the Liver (EASL) updated its guidelines in 2017 and introduced a new staging system for chronic HBV. Since these guidelines are relatively recent, data regarding the new staging is virtually absent in local/regional settings. Moreover, it has been observed that patients presenting to secondary care setups at major urban centers have disease characteristics quite distinct from those of their rural counterparts or patients presenting to tertiary care setups, even in the same cities. Additionally, there is scarce published data with regard to this aspect. With this study, we hope to make progress on all of those fronts.

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Molecular epidemiology of hepatitis delta and hepatitis B viruses circulating in two major provinces (East and North-West) of Pakistan

Cited by 15 publications

References 21 publications

Sero-Prevalence of Hepatitis D Virus Infection Among Hepatitis B Surface Antigen Positive Patients in Mashhad, Northeastern Iran

Sero-Prevalence of Hepatitis D Virus Infection Among Hepatitis B Surface Antigen Positive Patients in Mashhad, Northeastern Iran

The Severity of Hepatitis D in Young Adults of Age 18-25 Years

Demographics, Biochemical Characteristics, and Phases of Chronic Hepatitis B Virus Infection: Retrospective Analysis From a Secondary Care Setup

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