Lack of Anti-HDV Antibodies in HBsAg-Positive Children Two Decades after Compulsory HBV Vaccination: A Single Centre Study

Background: Hepatitis D Virus (HDV) infection is present worldwide and affects all age groups. About 5% of patients with chronic Hepatitis B Virus (HBV) infection are estimated to have HDV coinfection. HDV/HBV coinfection in children is associated with aggressive liver disease.Aim: To assess the prevalence of anti-HDV antibodies among a cohort of HBsAg-positive Egyptian children.Methods: This cross-sectional study included children who are HBsAg-positive, of both sexes, aged 1-18 years and were treatment-naïve. Laboratory tests including: Alanine aminotransferase, aspartate aminotransferase, HBsAg, HB-cIgG, HBeAg, anti-HBe antibodies, anti-HDV antibodies and HBV DNA quantitation.Results: Sixty-five children were included. Their median age was 5 years, (range 1-16 years) and 64.6% were males. The commonest possible risk of HBV acquisition was HBsAg-positive mothers in 97%. Among the studied children; 49.2% were immune tolerant, 9.2% were immune active, 24.6% were inactive carriers. Anti-HDV antibodies were negative in all cases.Conclusions: There is lack of evidence of HDV infection in our group of Egyptian HBsAg-positive children who were HBV-infected mostly perinatally.