HDV Seroprevalence in HBsAg Positive Patients

Objective: To find out the frequency of HDV seroprevalence and the demographic characteristics or HBsAg-HDV positive patients.

Study Design: Cross-sectional analytical study.

Place And Duration Of Study: Jinnah Postgraduate Medical Centre and Civil Hospital, Medical Unit-III, Karachi, from March 2007 to April 2011.

Methodology: Patients with positive HBsAg were included in the study. Those having co-infection with HCV or HIV, autoimmune hepatitis, alcoholic hepatitis, Wilson's disease and haemochromatosis were excluded. After detailed history and physical examination all the patients underwent laboratory workup including complete blood count, liver function test, viral profile (HAV, HCV, HIV and anti-HDV) and prothrombin time. While in selected patients, HBc (core) antibodies, ultrasound abdomen, serum iron profile, ANA and liver biopsy were also carried out whenever needed to establish a clinical stage of liver disease.

Results: There were 374 patients with 266 (71.1%) males and 108 (28.9%) females with overall mean age of 31.64 ± 8.66 years. Overall frequency of anti-HDV antibodies positivity was found in 28.1% (n = 105) patients. HDV seropositivity was slightly more prevalent in males as compared to females (28.57% vs. 26.57%). HDV seropositivity frequency was significantly higher in patients who presented with acute hepatitis/hepatic failure as compared to other clinical diagnoses (p = 0.027) and in those sub-sets of patients who had raised ALT levels (p = 0.012).

Conclusion: There was a high frequency of HDV seropositivity in the studied population particularly in males with acute hepatitis or hepatic failure, having raised ALT levels. The emphasis should be on preventive measures taken by other countries to reduce the prevalence of these treatment challenging infections.