Epidemiology and clinical outcome of hepatitis D virus infection in Turkey

Abstract

The prevalence, the epidemiology, the clinical and biochemical characteristics of hepatitis delta virus (HDV) infection were studied in patients with HBsAg-positive acute hepatitis, in those with chronic liver disease, and in apparently healthy carriers in Turkey. Fifty-eight of the 242 carriers of HBsAg (23.9%) and 31 of the 237 (13.1%) patients with acute HBsAg-positive hepatitis had serological evidence of HDV infection. Eleven of these individuals were HBsAg carriers with acute HDV superinfection. The prevalence of HDV infection was significantly (p less than 0.001) higher in patients with chronic liver disease (54/165; 32.7%) than in asymptomatic carriers of HBsAg (4/77; 5.2%). The highest prevalence (26/57; 45.6%) of HDV infection was found in patients at high risk of acquiring hepatitis virus infection (health care workers, hemodialysis patients, polytransfused patients) with chronic liver disease. Whereas the frequency of "severe" or fulminant hepatitis was similar in HBV infected patients (7.8%) and in HBV/HDV coinfected individuals (10%), the frequency of biphasic hepatitis was significantly (p less than 0.005) higher in the latter patients (30%) than in those with classical hepatitis B (7.8%). Chronic evolution of the disease was observed in 3.9% of the patients with classical hepatitis B and in 5% of those who had evidence of simultaneous HBV/HDV infection. The 10 carriers of HBsAg who survived the acute HDV superinfection developed chronic delta hepatitis. These findings indicate that HDV is endemic in Turkey and that its prevalence is highest among chronic HBsAg-positive hepatitis patients, implicating HDV as a major cause of liver disease among urban Turkis.

Acute hepatitis B virus infection in Turkey: epidemiology and genotype distribution

“…Most of the adult patients were immune to HAV infection. In early studies, the prevalence of HDV infection was reported as 23.9% in chronic HBV carriers, and the delta coinfection was detected in 20 (8.4%) of 237 patients [12], but in the present study, the rate of delta coinfection was only 0.6%. In Turkey, the There was no significant difference for all parameters between HBeAg-positive and anti-HBeAg-negative patients (p > 0.05).…”

Clinical outcome of acute and chronic hepatitis delta over time: a long-term follow-up study

“…One aspect of the study worth mentioning is the large number of acute HDV patients with adequate follow-up. Several studies in Italy, Turkey, and Greece have reported patients with HBV/HDV coinfection, but the follow-up is short [7,31,32]. In our study, we observed that 90% of patients with acute HBV and HDV coinfection cleared the infection in <6 months, with only two patients developing fulminant hepatitis and 8% developing chronic HDV.…”

Seropositivity of Delta Hepatitis in HBsAg Positive Patients in Eskişehir Province

“…In the same study, it was reported that this rate decreased to 2.9% after 2001 (6). Anti-HDV positivity in inactive hepatitis B carriers was determined to be 6.3% in İzmir by Yurtsever et Kaya et al (9,[15][16][17][18]. In a study performed by Us et al in Eskişehir province between 1995 and 1997, anti-HDV positivity in 50 inactive hepatitis B carriers was determined to be 2% (19).…”