High prevalence of chronic hepatitis D virus infection in Eastern Turkey: urbanization of the disease

Abstract

IntroductionBoth hepatitis B virus (HBV) and hepatitis D virus (HDV) infection play an increasingly important role in liver diseases. The main objective of this study was to investigate the socio-epidemiological, laboratory and radiological aspects of both HBV and HDV infection near the Iranian border of Turkey.Material and methodsThe study included 3352 patients with HBV and HDV infection. Socioepidemiological, laboratory and radiological aspects of the study subjects were retrospectively examined. Comorbid metabolic diseases were not assessed due to the retrospective design of the study.ResultsMost of the study subjects were HBe antigen negative. No significant difference in terms of HBV-DNA levels or HBe antigen seropositivity was detected between the city centre and rural areas (p > 0.005). The mean HBV-DNA level in the anti-HDV-positive group was significantly lower than in the anti-HDV-negative group (p < 0.001). The rate of HDV-RNA positivity in women was higher than in their male counterparts (p = 0.017). Anti-HDV-IgG was detected in 18.4% of tested subjects who came from an urban area. In contrast, 12.5% of subjects of the rural group had a positive result for anti-HDV-IgG. Among 134 ultrasonographically evaluated delta hepatitis patients, 37.3% had liver cirrhosis. On the other hand, in 1244 patients with hepatitis B monoinfection, there were 90 patients with liver cirrhosis. Radiologically, the rate of hepatic steatosis in delta hepatitis patients was lower than in those with HBV monoinfection.ConclusionsHepatitis D virus infection was particularly prevalent among the urban population as well as in female subjects. More broadly, the current observations are the first to suggest an inverse correlation between delta hepatitis and ultrasonography-proven hepatic steatosis.

Clinical and virological heterogeneity of hepatitis delta in different regions world‐wide: The Hepatitis Delta International Network (HDIN)

“…thrombocytopaenia (45%), elevated INR (23%)) are alarming. Importantly, the frequency of cirrhosis and hepatic decompensations reported for patients included in the HDIN data base is consistent with previously published single‐centre experiences, which mainly described European HDV genotype 1‐infected patients and reported cirrhosis in 34‐56% of cases . Recently, this high probability of liver related complications was also confirmed in the Swiss HIV/HDV cohort .…”

“…In line with previously studied cohorts of HBV mono-infected and HCV infected patients 25,26 our analysis confirmed that men are more often HDV infected than women. However, remarkable differences in 27,28 and reported cirrhosis in 34-56% of cases. [29][30][31][32][33] Recently, this high probability of liver related complications was also confirmed in the Swiss HIV/HDV cohort.…”

Hepatitis E virus infection in Turkey: a systematic review

“…HBV and HCV prevalences are 4 and 1% respectively [ 8 ]. Hepatitis D represents another considerable hepatitis etiology with a prevalence of 5–27% [ 9 ].…”

Frequency of Hepatitis Delta Virus in Hepatitis B Surfaceantigen-positive Patients

“…Epidemiological studies indicate that the rate of anti-HDV positivity is lower in the Far Eastern countries with high HBV endemicity and higher in the Mediterranean countries with moderate HBV endemicity (12). As in the world, HDV frequency also shows regional differences in Turkey ( Figure 2) (12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28). Higher rates were reported in the Eastern and Southeastern Anatolian regions.…”