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

BackgroundHepatitis B is a significant health problem and more than 350million 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 MethodsHBsAg-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. ResultsAmong 1038 individuals, HBsAg was detected in 660 (636%) cases following blood donation and in 378 (364%) cases following blood testing. In this study, 23 [22%, 95% confidence interval (CI)=13-32%] patients were HDV-seropositive. In HDV-seropositive patients, 14 (609%, 95% CI=391-783%) 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<001). Familial history of hepatitis D infection was more observed in HDV-seropositive patients than in individuals negative for anti-HDAb (P<001). ConclusionThe seroprevalence of HDV in HBsAg-positive individuals in this study was about 2% which seems to be lower than the global prevalence of HDV.