Seroprevalence of hepatitis B virus and its co-infection with hepatitis D virus and hepatitis C virus in Iranian adult population.

CONTEXT: Hepatitis B virus (HBV) infection is one of the most prevalent public health problems worldwide (especially in developing countries). AIMS: This study was carried out to determine the seroprevalence of HBV and its co-infection with hepatitis D (HDV) and C (HCV) viruses in the northeastern part of Iran. SETTING AND DESIGN: A population-based cross-sectional study in Iran. MATERIALS AND METHODS: As many as 1,850 subjects were explored for HBsAg. Anti-HDV and anti-HCV antibodies were assessed in HBsAg-positive cases. STATISTICAL ANALYSIS USED: Proportions were compared by Chi-square and Fisher's exact tests. RESULTS: The mean age of subjects was 43.86 +/- 11.2 years. The age- and sex-standardized prevalence for HBsAg positivity was 9.7%. It was higher in males than in females (OR: 1.28; 95% CI: 0.9-1.7). The risk of infection in singles was significantly higher than in married cases (OR: 2.13). Eight (5.8%) of HBsAg-positive cases were infected with HDV and 17 (12.3%) were positive for anti-HCV antibody. CONCLUSION: This study demonstrates that the prevalence of HBsAg seropositivity in Golestan province of Iran is higher than the levels reported by WHO and previous studies from Iran. It is very important, especially for health providers and policy makers, to recognize the risk factors of HBV infection and its co-infection with HDV and HCV in this area and design effective preventive programs.

Seroprevalence of hepatitis D virus in patients with hepatitis B virus-related liver diseases.

BACKGROUND AND OBJECTIVE: Several reports indicated a declining trend in the occurrence of hepatitis D virus (HDV) infection in some geographical areas. However, no study has been conducted in India to evaluate whether a similar epidemiological change is occurring in this part of the world. The present study was undertaken to evaluate the seroprevalence of HDV in patients with hepatitis B virus (HBV) related liver diseases attending a Government hospital in New Delhi, and to assess any change in its epidemiology by comparing the results with seroprevalence figures reported in the past. METHODS: A total of 123 patients with HBV-related liver diseases comprising 32 cases of acute viral hepatitis (AVH), 5 of fulminant hepatic failure (FHF), 37 of chronic hepatitis (CH), 46 of cirrhosis and 3 of hepatocellular carcinoma (HCC). All patients were evaluated for the presence of delta antibodies using commercially available ELISA kits. Both IgM and IgG anti-delta assays were performed to differentiate between active and convalescent infection. RESULTS: The mean age of the patients was 35.6 +/- 3.3 yr with a male : female ratio of 11:5. Of the 123 patients, serological evidence of delta virus infection was seen in 13 subjects (10.6%); 9 (7.3%) had evidence of past infection (IgG positive, IgM negative) and the remaining 4 (3.3%) recent infection (IgM anti-delta antibody positive). Evidence of HDV infection in acute viral hepatitis, fulminant hepatitis, chronic hepatitis, cirrhosis and hepatocellular carcinoma groups was found in 3.1, 20, 8.1, 15.2 and 33.3 patients, respectively. INTERPRETATION AND CONCLUSION: Our results suggest that delta infection may not be very common in Indian patients with HBV-related liver diseases. It is also possible that HDV epidemiology in this part of the world may be undergoing a transition towards decreasing prevalence.

Hepatitis viral delta

The etiologic agent of this severe form of hepatitis was identified by Rizzetto et al in Italy in 1977. The Delta virus resembles satellite viruses of plants which can not replicate without another specific virus. In this particular case hepatitis B virus is the helper agent. Clinically this form of hepatitis is characterized by two presentations: coinfeccion, which means simultaneous infection of a host with hepatitis B virus and hepatitis D virus. This variety of hepatitis can present with two distinct peaks of transaminases and usually resolves completely in most of the cases, however 0-4 percent can evolve to chronic hepatitis and 25 percent of the cases of fulminant hepatitis are due to this viral association. The diagnosis can be established demonstrating anti-HDV IgM or HDV-RNA or HDV antigen in the serum. In essence coinfection makers acute hepatic failure more common and the mortality is significantly higher than hepatitis B infections by itself. The second type of clinical presentation is superinfection, which means infection with the Delta virus of a patient previously infected with the hepatitis B virus (healthy carrier). Initially the patient develop a typical acute viral hepatitis in 50-70 percent of the cases, and 30-50 percent can have asymptomatic infection. The real problem with this presentation is that 20-90 percent of the cases evolved to chronicity: chronic active hepatitis and cirrhosis. The diagnosis can be made demonstrating anti-HDB IgM and anti-HDV IfG, although this last one is usually transitory. A liver biopsy can show HDV RNA or HDV antigen using special immunostainings...

Serologic classification of acute viral hepatitis at San Lazaro Hospital, Manila, Philippines.

Sixty-four out of 189 jaundiced patients at San Lazaro Hospital were defined as acute viral hepatitis cases. Of this number, 22 (34.4%) were positive for hepatitis A markers while 26 (40.6%) were positive for hepatitis B markers. Hepatitis D infection accounted for 1.6%, while non-A, non-B hepatitis accounted for 21.9%.