Abstract
Hepatitis delta virus (HDV), a satellite virus of hepatitis B virus (HBV), infects an estimated 15–20 million people worldwide and confers a greater risk for accelerated progression to liver disease. However, limited HDV surveillance data are available in sub-Saharan Africa where HDV diversity is high. To determine the prevalence and diversity of HDV in Cameroon, serological and molecular characterization was performed on 1928 HBsAg positive specimens selected from retrospective viral surveillance studies conducted in Cameroon from 2010–2016. Samples were screened for HDV antibodies on the Abbott ARCHITECT instrument and for HDV RNA on the Abbott m2000 instrument by research assays. HDV positive specimens with sufficient viral load were selected for genomic sequencing. The seroprevalence of HDV in HBsAg positive samples from Cameroon was 46.73% [95% CI; 44.51–48.96%], with prevalence of active HDV infection being 34.2% [95% CI; 32.09–36.41%]. HDV genotypes 1, 6, 7 and 8 were identified amongst N = 211 sequences, including N = 145 genomes. HDV prevalence is high within the study cohort, indicating that a large portion of HBV infected individuals in Cameroon are at elevated risk for severe hepatitis and death. Collectively, these results emphasize the need for HBV vaccination and HDV testing in HBsAg positive patients in Cameroon.
Highlights
Hepatitis delta virus (HDV) is the smallest virus known to infect humans
Despite the global burden of HDV, only 399 genome sequences are available in the National Center for Biotechnology (NCBI) repository, while 10,550 complete hepatitis B virus (HBV) genomes are available in the database
Blood samples collected from participants of two viral surveillance studies conducted from 2010–2016 were screened to identify N = 1928 HBV surface antigen (HBsAg)-positive specimens with sufficient volume for HDV screening[23,24]
Summary
Hepatitis delta virus (HDV) is the smallest virus known to infect humans. HDV infection is restricted to co-infection with hepatitis B virus (HBV) or superinfection of HBV-infected individuals due to the requirement for HBV surface antigen (HBsAg) in the HDV viral envelope. Samples have been collected in an ongoing HIV diversity surveillance study in urban centers of Cameroon (Fig. 1), HBV or HDV prevalence has not previously been examined in this cohort[24]. We retrospectively interrogated the HDV status of 1928 HBsAg-positive plasma samples from these two surveillance studies using recently developed automated research assays for detection of HDV IgG and HDV RNA on the Abbott ARCHITECT and m2000 platforms, respectively[25], and found a high prevalence of both HDV exposure (46.73% seropositive) and active infection (34.2% HDV RNA positive).
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