6533b838fe1ef96bd12a50f6

RESEARCH PRODUCT

Hepatitis delta virus infection in a large cohort of chronic hepatitis B patients in Ethiopia.

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Background Hepatitis D Virus (HDV)-infection is associated with a more severe outcome in patients with chronic hepatitis B (CHB); however, little is known about the presence of HDV in sub-Saharan Africa. We aimed to determine the prevalence of HDV-infection, as well as its clinical, biological and virological characteristics, in a large CHB cohort in Ethiopia. Methods In total, 1267 HIV-negative CHB patients at St. Paul's Hospital Millennium Medical College in Addis Ababa were screened for anti-HDV antibodies using ELISA assays. Confirmed positive samples were further tested for HDV RNA using a consensus commercial real-time RT-PCR assay. HDV genotypes were also determined for RNA positive samples by nucleotide sequencing followed by phylogenetic analyses. Demographic, clinical and biological data from patients were recorded and compared based on HDV RNA results. Results Most patients (n=748, 59.0%) were men and the median age was 31 years (interquartile range 26-40). Anti-HDV antibodies were detected in 19 individuals (1.5%), 12 of whom were HDV RNA positive with a viral load ranging from 8 log10 IU/ml. All strains were genotype 1. HDV RNA positive patients were more likely to have significant liver fibrosis (63.6 vs. 24.7%, p=0.007) and cirrhosis (45.5 vs. 16.4%, p=0.024). Conclusions HDV-infection is rare in Ethiopia, but is associated with more advanced liver fibrosis. This article is protected by copyright. All rights reserved.