Abstract
Hepatitis D virus infection (HDV) is considered the most severe form of viral hepatitis. In this study, we aimed to evaluate the prevalence of HDV infection in a tertiary center of a large, multi-ethnic city in the Netherlands. Moreover, we validate the reliability of a novel anti-HDV CLIA assay. All HBsAg-positive patients visiting the outpatient clinic between 2017 and 2019 were tested for HDV serology. Seropositive serum samples were further assessed by HDV RNA PCR and Sanger sequencing to identify the HDV genotype. The CLIA assay was 100% sensitive and 98% specific. Out of 925 patients 3.7% tested seropositive for HDV, and HDV viremia was confirmed in 2.0%. The majority of patients had a non-Dutch background and did not speak English or Dutch. We detected HDV genotype 5 (N=3), and genotype 1 (N=15). Phylogenetic analysis demonstrated HDV1 clusters composed of sub-Saharan Africa isolates, central Asian, Turkish, Iranian and European isolates. The prevalence of HDV infection in a tertiary center in the Netherlands was 2.0% among HBsAg-positive individuals, and mainly in non-Dutch individuals. Only HDV genotype 1 and 5 isolates were detected, which was found to match with the patient's country of origin.
Highlights
Hepatitis delta virus (HDV) infection is an important cause of liverrelated morbidity and mortality in patients infected with hepatitis B (HBV)
We identified one seropositive patient (CLIA level 8.3 AU/mL) who had been treated with peginterferon-α, resulting in undetectable HDV RNA serum levels
We evaluated the prevalence of HDV infection in a tertiary center of a large, multi-ethnic city in the Netherlands, and we validated the reliability of a recently developed anti-HDV chemiluminescent LIAISON® XL murex anti-HDV assay (CLIA) assay
Summary
Hepatitis delta virus (HDV) infection is an important cause of liverrelated morbidity and mortality in patients infected with hepatitis B (HBV). HDV infection only occurs in HBsAg-positive individuals as the viral life cycle of this satellite RNA virus requires hepatitis B surface antigen (HBsAg) as an envelope protein to mediate viral entry into hepatocytes [3]. Hepatitis D virus infection (HDV) is considered the most severe form of viral hepatitis. We aimed to evaluate the prevalence of HDV infection in a tertiary center of a large, multi-ethnic city in the Netherlands. We validate the reliability of a novel anti-HDV CLIA assay. Conclusions: The prevalence of HDV infection in a tertiary center in the Netherlands was 2.0% among HBsAgpositive individuals, and mainly in non-Dutch individuals. HDV genotype 1 and 5 isolates were detected, which was found to match with the patient’s country of origin
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