True prevalence of twin HDV-HBV infection in Pakistan: a molecular approach

Abstract

Hepatitis Delta Virus (HDV) infects only patients that are already infected by hepatitis B virus (HBV) because this is sub satellite virus which depends on and propagate only in the presence of HBV. HDV causes co-infection or super infection with sever complication as compared to only HBV infection. No study on molecular level on HDV is available from this region; therefore, the aim of this study was to found out the molecular epidemiology of HDV (as a co-infection with HBV) in different geographical regions of Pakistan.Total 228 HBsAg positive samples were received for the study from different geographical regions of the country. Only HBV DNA PCR positive samples were further utilized for the presence of HDV RNA. For this purpose, HDV RNA and HBV DNA was extracted and amplified using reverse transcriptase polymerase chain reaction (RT-PCR), nested PCR and real-time PCR.Out of the total 228 HBsAg positive samples, HBV DNA was detected in total 190 (83.3%) samples belonged to different patients. Of these 190 patients, HDV RNA was observed in 53 (28%) patients. Of the 53 HDV positive cases, 37 (69.8%) were males and 16 (30.2%) were female patients. The percentage of dual infection was found higher significantly (p < 0.05) in male patients as compared to female patients. Total 41 (26.8%) patients were below 40 years and 13 (31.7%) were above 40 years of age. No significant difference was seen in patients with ages above or below 40 years. In the provinces of Sindh, Khyber Pakhtoonkhaw and Punjab the observed prevalence of HDV was 67%, 6% and 4% respectively.In conclusion, the HDV infection is not uncommon in Pakistan and its prevalence is higher significantly in the Province of Sindh (p < 0.01) and male six (p < 0.05).

Prevalence of Hepatitis D Virus Infection Among Patients With Chronic Hepatitis B Attending Birjand Hepatitis Clinic (East of Iran) in 2012

“…In contrast to ours and other Iranian studies, they found a different HDV risk between both genders as 0.36 times less in women and concluded that it may be due to greater rate of high risk behaviors in men (22). Similar to the study of Zahedan, in Pakistan (eastern neighbor of Sistan and Balouchestan province), Khan et al (23) reported a rate of 28% for HDV and indicated a significantly higher rate of HDV among male patients, but regarding to age, no significant difference was seen in patients with ages above or below 40 years. Another study from Pakistan (24) found that 31.5% of their patients were anti-HDV positive and no significant difference was found between positive and negative groups regarding to age, gender, marital status, and place of residence.…”

New Enzyme-Linked Immunosorbent Assay for Detection of Antibodies against Hepatitis Delta Virus Using a Hepatitis Delta Antigen Derived from a Taiwanese Clone and Comparison to the Abbott Radioimmunoassay

“…The PCR program was as follows: 5 min at 95°C; 35 cycles of 1 min at 95°C, 1 min at 64°C, and 1 min at 72°C; and 10 min at 72°C. The expected size of the PCR product was 592 bp (11). No HDV RNA was detected in any of the three specimens.…”

Exploratory study of hepatitis D virus infection in HBsAg carriers in Abidjan, Cte Divoire in 2016

“…This situation might be explained by the high frequency of co-infection HDV/HBV in both populations. Patients between 30 and 40 years were most concerned about HDV infection in Nigeria but differ with the findings observed in Pakistan (Khan et al, 2011). This difference could be explained by the characteristics of the populations in different study particularly differences in proportions of the various categories of HBV and/or different study population profiles.…”