Prevalence of hepatitis D virus in HBs Ag positive multitransfused children

ABSTRACT

Polytransfusion with blood or blood products places recipient children at considerable risk of exposure to hepatitis B virus and hepatitis D virus viral infections. To evaluate the current risk of hepatitis D virus infection, this study was conducted in 105 polytransfused children and 50 primary school pupils as controls, a full history and complete clinical examination were done for each child with screening all of them for HBs Ag. The HBs Ag positive members were screened for anti HDV. HDV +ve samples were also tested for HBe Ag, anti HBe and anti HBc IgM. The anti HBc IgM +ve cases were further tested for anti HBs. Liver function tests [total serum bilirubin-alanine aminotransferase ALT] were done for HBs Ag +ve children. The results revealed that anti HDV is significantly prevalent among HBs Ag carries 72% [18 out of 25 cases] a finding which indicates that delta hepatitis is endemic in our locality and this is related to endemicity of HB infection 23% [25 out of 105 cases]. There is significant increase in prevalence of anti HDV [93%] among polytransfused children with history of parental injection-history of jaundice. 16 out of 18 cases [88.88%] of HDV infections were due to superinfection [absence of anti HBc IgM marker], while 2 out of 18 cases [11.11%] were due to co-infection [presence of both anti Bc IgM and anti HDV markers]. There was also significant increase in prevalence of anti HBe [a markers of good prognosis] more than HBe Ag among anti HDV +ve polytransfused children [p <0.05], but the liver function tests showed significant alteration in patients positive for anti HBe than those with negative anti HBe [p <0.001]