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

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.

Seroepidemiology of human T-cell lymphotropic virus among Iranian adult thalassemic patients.

BACKGROUND: A large number of transfusion-dependent thalassemic patients is at a substantial risk for transfusion-transmitted infections. Human T-cell lymphotropic virus (HTLV) is a blood-borne pathogen and can be transmitted via cellular products. We aimed to evaluate the seroprevalence of HTLV in transfusion-dependent thalassemic patients referred to Tehran Adult Thalassemia Clinic. METHODS: From 2008 to 2010, 257 transfusion-dependent thalassemic patients who referred to Tehran Adult Thalassemia Clinic were enrolled. The seroprevalence of HTLV, hepatitis B virus (HBV), hepatitis C virus (HCV), and HIV were assessed using enzyme-linked immunosorbant assay (ELISA). Also, the samples with positive result for anti-HTLVAb (by ELISA) were reassessed using Western blot for HTLV. RESULTS: Among the 257 transfusion-dependent thalassemic patients who were tested for anti-HTLVAb, 29 (11.3%, 95% CI = 7.8-15.6%) were found to be anti-HTLVAb positive by ELISA and Western blot. No case was detected to be HBsAg positive, whereas 16% had HBV seroconversion criteria, and more than 95% had anti-HBsAb in their sera. Also, 103 (40.1%) patients were HCV seropositive, 13 (5.1%) patients of which were co-infected with HCV/HTLV. Among the HTLV-infected patients, 44.8% were co-infected with HCV, whereas 39.5% of HTLV-seronegative individuals were HCV mono-infected (P > 0.05). CONCLUSION: This study showed that transfusion-dependent thalassemic patients were in higher risk for transmission of different blood-borne pathogens such as HTLV. The screening of HTLV in Iranian blood donors is recommended.