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

• Published in: Transfusion medicine (Oxford, England) Vol. 24; no. 6; pp. 411 - 417
• Main Authors: Keshvari, M., Alavian, S. M., Aghaee, B., Behnava, B., Mahdavi, M., Fesharaki, M. Gholami, Sharafi, H.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.12.2014
• Subjects: Adult; Aged; Blood Donors; Coinfection - blood; Coinfection - epidemiology; Female; hepatitis B; Hepatitis B - blood; Hepatitis B - epidemiology; Hepatitis B Surface Antigens - blood; Hepatitis B virus; hepatitis D; Hepatitis D - blood; Hepatitis D - epidemiology; Hepatitis D virus; Hepatitis Delta Virus; Hospitals, Special; Humans; Iran; Male; Middle Aged; RNA, Viral - blood; Seroepidemiologic Studies; viral load; Iran; hepatitis B; viral load; hepatitis D
• ISSN: 0958-7578; 1365-3148
• DOI: 10.1111/tme.12163

SUMMARY Background Hepatitis B is a significant health problem and more than 350 million individuals are infected with hepatitis B virus (HBV) globally. About 5% of these individuals are coinfected with hepatitis D virus (HDV). HBV–HDV coinfection increases the rate of fulminant hepatitis, chronic hepatitis and cirrhosis. This study aimed to evaluate the epidemiology of HDV in individuals positive for hepatitis B surface antigen (HBsAg) who were referred to Tehran Blood Transfusion Hepatitis Clinic from 2011 to 2012. Materials and Methods HBsAg‐positive individuals attending this clinic were tested for anti‐HDAg antibodies (anti‐HDAbs). All samples positive for anti‐HDAb were also tested for detection of HDV RNA by reverse transcription‐polymerase chain reaction (RT‐PCR). A questionnaire consisting of demographic characteristics and potential risk factors for acquisition of HDV was filled for each individual. Results Among 1038 individuals, HBsAg was detected in 660 (63·6%) cases following blood donation and in 378 (36·4%) cases following blood testing. In this study, 23 [2·2%, 95% confidence interval (CI) = 1·3–3·2%] patients were HDV‐seropositive. In HDV‐seropositive patients, 14 (60·9%, 95% CI = 39·1–78·3%) were positive for HDV RNA. HDV‐seropositive cases were more likely to have evidence of severe forms of hepatitis than the group of individuals without anti‐HDAb (P < 0·01). Familial history of hepatitis D infection was more observed in HDV‐seropositive patients than in individuals negative for anti‐HDAb (P < 0·01). Conclusion The seroprevalence of HDV in HBsAg‐positive individuals in this study was about 2% which seems to be lower than the global prevalence of HDV.