Seroprevalence of Delta Hepatitis in Patients with Chronic Hepatitis B and its Clinical Impact in Khuzestan Province, Southwest Iran

Hepatitis B virus (HBV) and hepatitis D virus (HDV) infections are major health problems in Iran.Preliminary reports indicate that HDV infection, a satellite virus of HBV, exists in this area. However, its prevalence inpatients with different types of liver diseases has not been studied in detail. This study was carried out to determine theseroprevalence of HDV among individuals who tested positive for hepatitis B surface antigen (HBsAg) in a southwesternprovince of Iran.Methods: In this cross-sectional study a total of 1,725 consecutive patients with HBV liver diseases attending the AhvazJundiShapur University Hospitals (AJSUH) and Hepatitis Clinics from 2002 to 2008 were included. We performed testsfor HBV and HDV serum markers, using commercially available enzyme-linked immunosorbent assay kits. Patients weresplit into two groups according to their HDV antibody (anti-HDV) status (HDV positive or negative). The collected datawere coded, and the statistical analyses were conducted.Results: The mean age of the patients was 37 ± 13/8 years. There were 1,157 males and 568 females. Of the 1,725patients with HBV liver disease, 150 were found to be reactive for anti-delta antibodies, yielding an overall HDV seroprevalenceof 11.5%. Anti-HDV was found in 3.59% of patients with inactive chronic hepatitis, 45.5% of patients withchronic active hepatitis, and 43.2% of cirrhotic and hepatocellular carcinoma patients (P 0.001). A higher proportionof individuals testing positive for antibodies to HDV were observed among males (72%) than among females (28%). Thepatients without HDV infection were younger than anti-HDV-positive/HBsAg-positive patients (P 0.01).Conclusions: HDV infection was common in patients with HBV in our community. All HBV patients should be screened forHDV infection. The results indicate that HDV co-infection was related to the severity of the liver disease. More studiesdesigned to elucidate HDV’s epidemiology are needed.