Subject(s)
Crohn Disease/complications , Ileal Diseases/diagnosis , Intestinal Fistula/diagnosis , Urinary Bladder Fistula/diagnosis , Adult , Diagnostic Imaging , Humans , Ileal Diseases/etiology , Ileal Diseases/therapy , Intestinal Fistula/etiology , Intestinal Fistula/therapy , Male , Urinary Bladder Fistula/etiology , Urinary Bladder Fistula/therapyABSTRACT
The aims of this study were twofold: (1) to determine the prevalence and clinical features of hepatitis delta virus (HDV) infection among subjects positive for hepatitis B surface antigen (HBsAg) living in the Miyako Islands, Okinawa Prefecture, Japan, and (2) to clarify the relationship between HDV-RNA level and severity of HDV-related liver disease. One hundred and ninety-nine HBsAg-positive subjects (123 asymptomatic carriers [ASCs], 3 patients with acute hepatitis [AH], 50 patients with chronic hepatitis [CH], 15 patients with liver cirrhosis [LC], and 8 patients with hepatocellular carcinoma [HCC], were tested for antibody to HDV (anti-HDV) by radioimmunoassay. Anti-HDV-positive individuals were examined to determine semi-quantified HDV-RNA level by polymerase chain reaction (PCR). The overall prevalence of anti-HDV among the 199 subjects was 21.1%. The positivity rate tended to increase with age or the severity of the underlying liver disease: anti-HDV-positive rates were 10.6% (13/123) in ASCs, 32.0% (16/50) in patients with CH, 40.0% (6/15) in patients with LC, and 87.5% (7/8) in patients with HCC. None of the patients with AH were positive for anti-HDV. There was no correlation between semi-quantified serum HDV-RNA levels and the severity of chronic liver disease in patients positive for anti-HDV. The present study showed the local spread of HDV infection in the Miyako Islands, Okinawa, Japan. Although the anti-HDV positivity rate tended to increase with the severity of the underlying liver disease, the severity of HDV-related liver disease did not correlate with the semi-quantified serum HDV-RNA level.
Subject(s)
Hepatitis D/diagnosis , Hepatitis D/epidemiology , Hepatitis Delta Virus/isolation & purification , Adolescent , Adult , Age Distribution , Aged , Aged, 80 and over , Base Sequence , Cross-Sectional Studies , Female , Humans , Japan/epidemiology , Male , Middle Aged , Molecular Sequence Data , Polymerase Chain Reaction , Prevalence , RNA, Viral/analysis , Risk Factors , Rural Population , Serologic Tests/methods , Sex DistributionABSTRACT
A seroepidemiological study was performed to clarify the prevalence of hepatitis delta virus (HDV) infection among the general population in the Irabu islands, Okinawa, Japan. Of 2028 healthy people examined who had received their annual health check-up in 1994-95, 195 (9.6%) were positive for hepatitis B surface antigen (HBsAg). Of these 195 HBsAg-positive individuals, 46 (23.6%) showed a positive reaction for antibody to HDV (anti-HDV). The positivity rate of anti-HDV among HBsAg-positive subjects tended to increase with age up to 50-59 years of age. The prevalence of anti-HDV also varied among the seven districts in the islands (0-63.3%). None of the anti-HDV-positive subjects was included in the high risk group for parenterally transmitted diseases. The unusually high prevalence of anti-HDV among HBsAg-positive individuals, particularly in the older age groups, seemed to reflect the natural prevalence or previous HDV infection, rather than a current or imported infection of HDV. Although the great majority of HBsAg-positive subjects with anti-HDV were asymptomatic, abnormally high values of serum transaminases were more frequently seen in these subjects compared with HBsAg-positive subjects without anti-HDV.
Subject(s)
Hepatitis D/epidemiology , Adult , Age Factors , Aged , Female , Hepatitis Antibodies/blood , Hepatitis B/epidemiology , Hepatitis B Surface Antigens/blood , Hepatitis Delta Virus/immunology , Humans , Japan/epidemiology , Male , Middle Aged , Prevalence , Seroepidemiologic StudiesABSTRACT
A seroepidemiological study on hepatitis delta virus (HDV) infection was conducted in the Okinawan islands, the area of Japan where hepatitis B virus infection is most prevalent. The subjects of this study included 116 asymptomatic hepatitis B surface antigen (HBsAg) carriers, 48 patients with chronic hepatitis (CH), 19 with liver cirrhosis (LC), and 11 with hepatocellular carcinoma (HCC). Among the 194 serum samples examined, a total of 10 (5.2%) were anti-HDV seropositive. Anti-HDV was detected in 2 (1.7%) of the 116 asymptomatic HBsAg carriers, in 3 (6.3%) of the 48 patients with CH, and in 5 (26.3%) of the 19 with LC. However, none of the patients with HCC had detectable anti-HDV. Eight of the 10 were born in the Miyako island group and the remaining 2 on the main island of Okinawa. Since the subjects included 34 individuals who were living and/or born in the Miyako islands, the positive rate of anti-HDV in the islands was 23.5%. This study demonstrates the existence of an endemic area of HDV infection in Japan.
