<scp>HBV</scp>/<scp>HDV</scp> co‐infection in the <scp>W</scp>estern <scp>B</scp>razilian <scp>A</scp>mazonia: an intriguing mutation among <scp>HDV</scp> genotype 3 carriers

Kay, Alan; Silva, E. Melo da; Pedreira, H.; Negreiros, S.; Lobato, Cirley; Braga, Wornei Silva Miranda; Muwonge, Richard; Dény, Paul; Reis, Mitermayer Galvão dos; Zoulim, Fabien; Trépo, Christian; Júnior, Argemiro D’Oliveira; Salcêdo, Juan Miguel Villalobos; Schinoni, María Isabel; Paraná, Raymundo

doi:10.1111/jvh.12267

Cited by 17 publications

(24 citation statements)

References 9 publications

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“…These results corroborate those of previous studies that have shown a higher prevalence of these genotypes in the Amazon region and have demonstrated that they are commonly associated with severe hepatitis delta outbreaks [12,23,24,27,38,51,52,53,54]. The HDV-1 genotype characterized in this study has been isolated from non-Amerindian individuals at a frequency of 7.6%.…”

Section: Discussionsupporting

confidence: 81%

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Characterization of the Genotypic Profile of Hepatitis Delta Virus: Isolation of HDV Genotype-1 in the Western Amazon Region of Brazil

Botelho-Souza¹,

Vieira²,

Santos³

et al. 2015

Intervirology

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The hepatitis delta virus (HDV) is a hepatotropic subvirus that is dependent on the hepatitis B virus (HBV) and supplies the viral envelope containing the surface antigen of hepatitis B. Viral genetic diversity is related to the geographical origin of the isolates, and there are at least eight genotypes that are referred to as HDV-1 through HDV-8. HDV-3 is responsible for epidemics of severe and fulminant hepatitis, which are common in northeastern South America. HDV-3 is prevalent in the Brazilian Amazon and is associated with the increased aggressiveness of HDV infections. Although isolated, the characteristics of the clinical presentation of HDV-1 in the Amazon region have not yet been clearly reported. Objective: This study aims to assess the genotypic and clinical characteristics of individuals with the HDV-1 genotype in the western Amazon region. Methods: The HDV was genotyped by nested PCR-RFLP and sequencing from serum samples of 56 patients with HBV/HDV infection. The genotypes were correlated with the clinical characteristics presented by patients with HBV/HDV infection. Results: A prevalence of 92.3% for the HDV-3 genotype (n = 48) and 7.6% (n = 4) for the HDV-1 genotype was observed. Conclusion: To date, this is the most extensive clinical study of HDV-1 genotype infections in the nonindigenous population of Western Amazonia.

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Section: Discussionsupporting

confidence: 81%

“…This might be related to the high rate of endemicity for HBV in the region [51] and the presence of an indigenous population. Previous studies have indicated a high prevalence of HDV infection in Amerindian people from the Amazon region [23,24,38,52]. …”

Section: Discussionmentioning

confidence: 99%

Characterization of the Genotypic Profile of Hepatitis Delta Virus: Isolation of HDV Genotype-1 in the Western Amazon Region of Brazil

Botelho-Souza¹,

Vieira²,

Santos³

et al. 2015

Intervirology

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“…However, this test was evaluated in a limited sample of a central European cohort infected by genotype-1 HDV that was included in a clinical trial (HIDIT-2; NCT00932971). Thus, further prospective studies might be needed to be used in regions with different HDV genotypes, such as Amazon basin where HDV-3 is the most frequent genotype [28]. …”

Section: Discussionmentioning

confidence: 99%

Prevalence and predictors for compensated Advanced Chronic Liver Disease (c-ACLD) in patients with chronic Hepatitis Delta Virus (HDV) infection

et al. 2017

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ObjectiveThe study aimed to evaluate the prevalence and predictor factors for compensated advanced chronic liver disease (c-ACLD) in patients with hepatitis Delta virus (HDV) infection.MethodsThis cross-sectional study included consecutive HDV-infected patients defined by positive anti-HDV. Patients with hepatitis C coinfection, liver transplantation or presence of conditions that limit liver (LSM) or spleen stiffness measurement (SSM) were excluded. Blood tests, abdominal ultrasound, SSM and LSM by transient elastography (FibroScan®) were performed at the same day. Alcohol consumption was quantified using the AUDIT score and c-ACLD was defined by LSM ≥ 15 kPa performed by an experimented operator blinded for clinical and laboratory data.Results101 patients were eligible and few patients were excluded due to negative anti-HDV (n = 7), hepatitis C coinfection (n = 2), liver transplantation (n = 10) and limitation for LSM or SSM (n = 5). Therefore, 77 patients [61% male, age = 43 (IQR,36–52) years] were included. The prevalence of c-ACLD was 57% (n = 44/77). Patients with c-ACLD had a higher rate of detectable HBV viral load (p = 0.039), higher levels of transaminases, GGT, alkaline phosphatases, total bilirubin and INR (p<0.001 for all), as well as lower platelet count and albumin levels (p>0.001 for both) compared to those without c-ACLD. Patients with c-ACLD had higher SSM [65.2 (IQR,33.8–75.0) vs 21.8 (16.5–32.0) kPa; p<0.001] and higher splenic volume [475 (IQR,311–746) vs 154 (112–283) cm3; p<0.001] compared to those without. Detectable HBV viral load (>10 UI/ml), alkaline phosphatase (per IU/L) and GGT levels (per IU/L) were independently associated with c-ACLD in all multivariate models. Splenic volume [per cm3,OR = 1.01 (95%CI,1.01–1.02);p = 0.002], SSM [per kPa, OR = 1.04 (1.01–1.07);p = 0.012] and splenomegaly [yes vs no,OR = 28.45 (4.42–182.95);p<0.001] were independently associated with c-ACLD.ConclusionsThe prevalence of c-ACLD was high in patients with chronic HDV infection in western Amazon basin. HBV viral load, liver enzymes and splenic features can be used to predict severe liver disease in HDV-infected patients.

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“…HDV RNA was amplified by RT‐PCR and seminested PCR using specific primers in the small delta antigen region (sHD) . RT‐PCR was carried out using the AffinityScript One‐Step RT‐PCR kit (Agilent Technologies).…”

Section: Methodsmentioning

confidence: 99%

“…HDV/HBV‐F coinfection was often found and always associated with severe liver disease . However, recent studies revealed new combinations of HDV/HBV‐non‐F genotypes that are also associated with a similar clinical picture …”

Section: Introductionmentioning

confidence: 99%

Non‐F HBV/HDV‐3 coinfection is associated with severe liver disease in Western Brazilian Amazon

Silva

Kay

Lobato

et al. 2019

Journal of Medical Virology

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The clinical outcome of hepatitis B virus (HBV) infection may be related to host and viral genetic factors, as well as to the type of infection (monoinfection and coinfection). To analyze the distribution/combination of HBV/hepatitis D virus (HDV) genotypes and the associated clinical characteristics, 409 serum samples from patients with chronic HBV (94 of them coinfected by HDV) followed at the Viral Hepatitis Referral Center of Rio Branco, Brazil were enrolled. HBV DNA and HDV RNA were amplified, respectively, by polymerase chain reaction (PCR) and nested PCR using specific primers in the PreC/C region and the S gene, and by reverse‐transcription PCR and seminested PCR using specific primers in the delta antigen region and sequenced. The proportion of women (56.1%) was significantly higher than males in this cohort ( P < 0.01). Women were significantly younger (39.8 years; 8‐77 years) than males (44.7 years; 12‐79 years; P < 0.01). Sixty‐eight (18%) patients were infected with HBV‐F genotype and 264 (69.8%) with HBV/non‐F genotypes. Coinfection by HDV was detected in 23.9% (94 of 409) of this population and was more frequent in male (54.2%, 51 of 94) than in female patients (44.7%, 42 of 94; P = 0.015). HDV‐3 was the most prevalent (88.9%) genotype. Almost 70% of HDV‐3 coinfected patients were infected with HBV/non‐F genotypes. Severe liver disease was diagnosed in 41 patients, 60.9% (25 of 41) of them coinfected with HDV. HBV/HDV coinfection was associated with male sex, age above 30 years, severe liver disease, and increased alanine aminotransferase levels. HBV/HDV‐3 coinfection is associated with severe liver disease, in Rio Branco, Brazil.

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HBV/HDV co‐infection in the Western Brazilian Amazonia: an intriguing mutation among HDV genotype 3 carriers

Cited by 17 publications

References 9 publications

Characterization of the Genotypic Profile of Hepatitis Delta Virus: Isolation of HDV Genotype-1 in the Western Amazon Region of Brazil

Characterization of the Genotypic Profile of Hepatitis Delta Virus: Isolation of HDV Genotype-1 in the Western Amazon Region of Brazil

Prevalence and predictors for compensated Advanced Chronic Liver Disease (c-ACLD) in patients with chronic Hepatitis Delta Virus (HDV) infection

Non‐F HBV/HDV‐3 coinfection is associated with severe liver disease in Western Brazilian Amazon

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