Retrospective Evaluation of Hepatitis Delta Virus Seroprevalence in HBsAg-Positive Patients

Abstract

Hastaların aynı başvuru sırasında incelenen diğer hepatit B serolojik belirteçleri, HBV-DNA düzeyleri, anti-HCV ve anti-HDV test sonuçları ile karaciğer transaminazları, serum albümin ve bilirubin düzeyleri, trombosit sayısı ve INR değerleri de geriye dönük olarak hastane kayıtlarından incelendi.Bulgular: HBsAg pozitif hastaların %3.6'sında anti-HDV testi pozitif saptandı. Anti-HDV pozitiflik oranının erkek olgularda kadınlardan daha düşük olduğu belirlendi (p=0.009). Yıllara göre anti-HDV pozitiflik oranlarında istatistiksel olarak anlamlı farklılık görülmedi (p>0.05). Anti-HDV negatif olgularda HBV-DNA pozitifliğinin, anti-HDV pozitif hastalardan yüksek olduğu belirlendi (p=0.001). Anti-HDV negatif olgularda anti-HBe pozitiflik oranının, anti-HDV pozitif olgulardan yüksek olduğu saptandı (p=0.001). Delta antikoru saptanan hastalarda trombosit sayısı ve albümin değerlerinin antikor saptanmayan hastalara göre düşük olduğu görülürken, INR değerleri yüksek bulundu (p<0.01). Sonuç: HBsAg pozitif hastalarda %3.6 oranında saptanan anti-HDV pozitifliğinin ülkemizde özellikle batı bölgelerde yapılan çalışmalar ile uyumlu olduğu görülmektedir. Hepatit D enfeksiyonunun klinik seyri göz önüne alındığında, hepatit B enfeksiyonlu hastaların hepatit D açısından taranması ve izlemi bu hastalığın yönetimi açısından oldukça önem taşımaktadır.

The changing epidemiology of delta hepatitis in Türkiye over three decades: A systematic review

“…During the study period of 35 years, 111 publications were found 13–123 . Among inactive HBV carriers, 34 studies reported HDV prevalence and it did not change significantly over three decades 6,13–45 (Table 1).…”

“…(Table 2). Seventeen studies included all HBsAg‐positive patients without further describing patients' characteristics and reported decreasing (from Period 1 to Period 2, 7.0%–3.0%) and then increasing (from Period 2 to Period 3, to 4.7%) HDV prevalence 6,66–81 . Cumulative data of these three groups were taken to reveal HDV prevalence in HBV‐infected patients, and it showed decreasing (from Period 1 to Period 2) followed by increasing (from Period 2 to Period 3) HDV prevalence (Table 3 and Figure 2).…”

“…[91][92][93][94] HBV-positive haemodialysis patients from 1991 to 1998 reported 0%-35% of HDV prevalence. 20,22,66,[95][96][97] HDV prevalence among the patients with acute hepatitis B decreased significantly over the periods: 125/1124 (11%), 61/930 (6.6%) and 14/336 (4.2%) (p < .00001), 13,14,17,18,20,22,23,25,27,[30][31][32]35,38,44,47,53,[98][99][100][101][102][103][104][105] HBVpositive patients with hepatocellular carcinoma reported no significant change in HDV prevalence over the periods (14/80, 17.5%; 24/130, 18.5%; 129/934, 13.8%), 13,39,81,[107][108][109][110] and studies in miscellaneous groups of patients reported 0%-54% of prevalence. 6,41,[107][108][109]…”

“…Seventeen studies included all HBsAg-positive patients without further describing patients' characteristics and reported decreasing (from Period 1 to Period 2, 7.0%-3.0%) and then increasing (from Period 2 to Period 3, to 4.7%) HDV prevalence. 6,[66][67][68][69][70][71][72][73][74][75][76][77][78][79][80][81] Cumulative data of these three groups were taken to reveal HDV prevalence in HBV-infected patients, and it showed decreasing (from Period 1 to Period 2) followed by increasing (from Period 2 to Period 3) HDV prevalence (Table 3 and Figure 2). Cumulative data of these three groups were analysed according to the geographic regions of the country: Southeastern Anatolia (22.4%), Eastern Anatolia (8.4%) and Central Anatolia (8.2%) regions had the highest prevalence in Period 1, and their respective changes in Period 2 and Period 3 were as follows: 8.5%-6.8%, 14.8%-10.2% and 2.6%-3.2% (p < .00001 for all three regions).…”