The epidemiology and clinical outcome of hepatitis D virus (delta) infection in Jordan

Abstract

The epidemiology and clinical outcome of hepatitis D viral infection in HBsAg-positive acute hepatitis, chronic liver disease, primary hepatocellular carcinoma and the symptomless carrier state was studied in Jordan. The prevalence of hepatitis D viral infection was significantly higher in patients with chronic liver disease (18/79, 23%) and acute hepatitis (17/108, 16%) than in symptomless HBsAg carriers (2/136, 2%). The highest prevalence of hepatitis D viral infection was found in patients with primary hepatocellular carcinoma (10/15, 67%) who were also significantly older than such patients without hepatitis D viral infection. Antihepatitis D virus IgM was detected persistently in 83% of patients with antihepatitis D virus-positive chronic liver disease and transiently in 41% of patients with acute hepatitis. A trend to increased mortality was observed in acute hepatitis D viral superinfection (25%) compared to hepatitis D viral coinfection (0%) and to antihepatitis D virus-negative HBsAg-positive acute hepatitis (4%). In patients with established chronic liver disease, however, neither survival nor histological parameters of disease activity were significantly different in the antihepatitis D virus-positive and antihepatitis D virus-negative groups. While the early stage of hepatitis D viral superinfection is associated with increased mortality, it appears that in patients with late-stage chronic liver disease, severe histological activity subsides, and survival is no longer influenced by the factor of hepatitis D viral infection. However, primary hepatocellular carcinoma appears to complicate the course of those antihepatitis D virus-positive patients surviving beyond this stage.

Epidemiology and viral risk factors for hepatocellular carcinoma in the Eastern Mediterranean countries

“…Two studies from Turkey show prevalence of anti-HDV in 18.8% to 23.0% of HBsAg positive HCC [37,76] . A Jordanian study reported the prevalence of anti-HDV in a small group of HBsAg positive HCC patients was 67%, but the sample size was very small [77] . The risk of HCC is increased in HDV infection compared to HBV monoinfection.…”

Hepatocellular carcinoma in Yemeni patients: a single centre experience over an 8-year period

“…Epidemiologic data from neighbouring countries differ widely with regard to primary risk factors. It has been attributed to hepatitis C virus (HCV) infection in Saudi Arabia [8,9], hepatitis B virus/hepatitis D virus (HBV/HDV) infection in Jordan [10] and HBV and HCV in Turkey [11,12].…”

Delta Hepatitis

“…Epidemiologic studies will be discussed according to different geographic areas below. The prevalence rate of HDV infection in asymptomatic HBV carriers was reported as 2%, 31%, and 3.3% in Jordan, Kuwait, and Saudi Arabia, respectively [17][18][19]. In chronic liver diseases, it was reported as 23.5%, 23%, 2%, and 10% in Egypt, Jordan, Yemen, and Iran respectively [15,17,[20][21][22].…”

“…The prevalence rate of HDV infection in asymptomatic HBV carriers was reported as 2%, 31%, and 3.3% in Jordan, Kuwait, and Saudi Arabia, respectively [17][18][19]. In chronic liver diseases, it was reported as 23.5%, 23%, 2%, and 10% in Egypt, Jordan, Yemen, and Iran respectively [15,17,[20][21][22]. The prevalence of HDV infection was low (0.5% to 13.3%) in Japan except in some islands of Okinawa, Russia except in Yakutia (18-20%), Korea, Indonesia (< 0.05%), Malaysia, Thailand (0.7%), Philippines and Vietnam (1.3%), and Lebanon (1.2%) [22].…”