Abstract
Hepatitis B virus (HBV) infections account for approximately 780,000 deaths per year, most of which occur in the developing world. Co-infection with HBV and hepatitis delta virus (HDV) may lead to the most severe form of viral hepatitis. In Ghana, knowledge on the prevalence of HBV and HDV in the general population is scanty and the few genetic analyses of the prevailing HBV genotypes are dating back more than a decade. In the present study, 1,323 serum samples from individuals living in a rural area (Offin river valley) of Ghana were analyzed for the presence of the hepatitis B surface antigen (HBsAg). Positive sera were subsequently tested for the presence of anti-HDV antibodies. A total of 107 (8%) sera were HBsAg positive with an 8.4% prevalence of anti-HDV antibodies among the HBsAg positives. Phylogenetic analysis based on HBV pre-S/S sequences, attributed all 52 typable samples to genotype E. All belonged to serotype ayw4. While 19 sequences clustered with those from a number of African countries, the other 33 formed a separate cluster distinguished by an intergroup mean distance of 1.5% from the pan-African HBV/E cluster. Successful implementation of HBV vaccination in the region was reflected by the low HBsAg carrier rate of 1.8% among children ≤11 years.
Highlights
Despite the availability of effective hepatitis B virus (HBV) vaccines, the global burden of hepatitis B remains high, with an estimated 240 million chronically infected individuals and about 780,000 deaths from cirrhosis and hepatocellular carcinoma each year [1]
This frequency of co-infection is similar to that observed in a recent study conducted in Accra, where a hepatitis delta virus (HDV) seroprevalence of 11.3% was found among 53 patients with HBV-related liver disease [38]
While the administration of the hepatitis B vaccine at birth or in early childhood has been effective in reducing the incidence of the disease in many endemic regions [52, 53], immunization programs will not benefit patients already chronically infected with HBV
Summary
Despite the availability of effective hepatitis B virus (HBV) vaccines, the global burden of hepatitis B remains high, with an estimated 240 million chronically infected individuals and about 780,000 deaths from cirrhosis and hepatocellular carcinoma each year [1]. HBV isolates have been classified into eight confirmed (A to H) [3,4,5,6,7] and two tentative (I and J) [8, 9] genotypes, based on a divergence of >7.5% in the whole genome, or >4% in the S gene sequence. In recent years it has become increasingly evident that a distinct global geographical distribution of HBV genotypes is a major factor responsible for differences observed in clinical manifestations and response to antiviral treatment and vaccination [10,11,12], emphasizing the importance of genotyping studies to identify the locally prevailing genotypes
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