Hepatitis delta virus infection in a large cohort of chronic hepatitis B patients in Ethiopia. (20th October 2017)

• Record Type: Journal Article
• Authors: Aberra, Hanna; Gordien, Emmanuel; Desalegn, Hailemichael; Berhe, Nega; Medhin, Girmay; Mekasha, Bitsatab; Gundersen, Svein G.; Gerber, Athenaïs; Stene‐Johansen, Kathrine; Øverbø, Joakim; Johannessen, Asgeir
• Is Part Of: Liver international. Volume 38:Number 6(2018)
• Page Start: 1000
• Page End: 1009
• Publication Date: 2017-10-20
• Subjects: HDV genotype -- hepatitis delta virus -- liver fibrosis -- molecular assays -- serology -- sub‐Saharan Africa; Liver -- Periodicals; Liver -- Diseases -- Periodicals; 616.362
• DOI: 10.1111/liv.13607
• Languages: English
• ISSNs: 1478-3223

Abstract

Abstract: Background & Aims: Hepatitis D virus (HDV) infection is associated with a more severe outcome in patients with chronic hepatitis B (CHB); however, little is known about the presence of HDV in sub‐Saharan Africa. We aimed to determine the prevalence of HDV infection, as well as its clinical, biological and virological characteristics, in a large CHB cohort in Ethiopia. Methods: In total, 1267 HIV‐negative CHB patients at St. Paul's Hospital Millennium Medical College in Addis Ababa were screened for anti‐HDV antibodies using ELISA assays. Confirmed positive samples were further tested for HDV RNA using a consensus commercial real‐time RT‐PCR assay. HDV genotypes were also determined for RNA‐positive samples by nucleotide sequencing followed by phylogenetic analyses. Demographical, clinical and biological data from patients were recorded and compared based on HDV RNA results. Results: Most patients (n = 748, 59.0%) were men, and the median age was 31 years (interquartile range 26‐40). Anti‐HDV antibodies were detected in 19 individuals (1.5%), 12 of whom were HDV RNA‐positive with a viral load ranging from <2 to >8 log 10 IU/mL. All strains were genotype 1. HDV RNA‐positive patients were more likely to have significant liver fibrosis (63.6% vs 24.7%, P = .007) and cirrhosis (45.5% vs 16.4%, P = .024). Conclusions: HDV infection is rare in Ethiopia but is associated with more advanced liver fibrosis.