Abstract
BackgroundPatients coinfected with HBV and hepatitis D virus (HDV) have a greater risk of HCC and cirrhosis. The current study was undertaken to assess HDV genotype distribution and determine clinical characteristics of hepatitis delta virus (HDV) among HBsAg positive individuals in Shanghai.MethodThis retrospective study involved 225 serum samples from HBsAg positive hospitalized patients from October 2010 to April 2013. HDV-specific RT-nested PCR was used to amplify HDV RNA. HDV genotypes were characterized by Next-generation sequencing (NGS), followed by phylogenetic analyses. HDV/HBV co-infected patients and HBV mono-infected patients were compared clinically and virologically.ResultsOut of the 225 HBsAg-positive serum samples with elevated transaminases, HDV-RNA was identified in 11 (4.9%) patients. The HBV loads in the HDV positive group were significantly lower than the HDV negative HBV-infected patients. The aminotransferase enzymes were significantly higher in HDV/HBV co-infected compared to HDV negative patients (P < 0.05). Phylogenetic analyses indicated that HDV-2 genotype being the predominant genotype, other HDV genotypes were not observed. HDV/HBV patients were significantly associated with a rather unfavourable clinical outcome.ConclusionIn summary, the prevalence of HDV infection in patients with elevated transaminases is not low and the predominance of HDV genotype 2 infection in Shanghai. This finding helps us to better understand the correlation of HDV/HBV co-infection. Moreover, Next-generation sequencing (NGS) technologies provide a rapid, precise method for generating HDV genomes to define infecting genotypes.
Highlights
Patients coinfected with hepatitis B virus (HBV) and hepatitis D virus (HDV) have a greater risk of Hepatocellular carcinoma (HCC) and cirrhosis
The aminotransferase enzymes were significantly higher in HDV/HBV co-infected compared to HDV negative patients (P < 0.05)
Phylogenetic analyses indicated that HDV-2 genotype being the predominant genotype, other HDV genotypes were not observed
Summary
Patients coinfected with HBV and hepatitis D virus (HDV) have a greater risk of HCC and cirrhosis. The current study was undertaken to assess HDV genotype distribution and determine clinical characteristics of hepatitis delta virus (HDV) among HBsAg positive individuals in Shanghai. In some regions of the world with vaccination campaigns against HBV, the prevalence of HDV infection has significantly declined. Prevalence of HDV infection is higher in areas where HBV infection is endemic, as well as the central Europe because of the immigrant population regions. HDV-4 (previously 2b) is found in Japan and Taiwan, whereas genotypes 5–8 are described in individuals of African origin [5]. China is one of the countries with the highest number of hepatitis B virus infections in the world, no nationwide cohort study has been conducted to assess the prevalence of HDV infection
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