Seroprevalence of hepatitis D virus in patients with hepatitis B virus-related liver diseases

Abstract

Background & objectives: Several reports indicated a declining trend in the occurrence of hepatitis D virus (HDV) infection in some geographical areas. However, no study has been conducted in India to evaluate whether a similar epidemiological change is occurring in this part of the world. The present study was undertaken to evaluate the seroprevalence of HDV in patients with hepatitis B virus (HBV) related liver diseases attending a Government hospital in New Delhi, and to assess any change in its epidemiology by comparing the results with seroprevalence figures reported in the past. Methods: A total of 123 patients with HBV-related liver diseases comprising 32 cases of acute viral hepatitis (AVH), 5 of fulminant hepatic failure (FHF), 37 of chronic hepatitis (CH), 46 of cirrhosis and 3 of hepatocellular carcinoma (HCC). All patients were evaluated for the presence of delta antibodies using commercially available ELISA kits. Both IgM and IgG anti-delta assays were performed to differentiate between active and convalescent infection. Results: The mean age of the patients was 35.6 ± 3.3 yr with a male : female ratio of 11:5. Of the 123 patients, serological evidence of delta virus infection was seen in 13 subjects (10.6%); 9 (7.3%) had evidence of past infection (IgG positive, IgM negative) and the remaining 4 (3.3%) recent infection (IgM anti-delta antibody positive). Evidence of HDV infection in acute viral hepatitis, fulminant hepatitis, chronic hepatitis, cirrhosis and hepatocellular carcinoma groups was found in 3.1, 20, 8.1, 15.2 and 33.3 patients, respectively. Interpretation & conclusion: Our results suggest that delta infection may not be very common in Indian patients with HBV-related liver diseases. It is also possible that HDV epidemiology in this part of the world may be undergoing a transition towards decreasing prevalence.