Abstract
Hepatitis Delta Virus (HDV) infects only patients that are already infected by hepatitis B virus (HBV) because this is sub satellite virus which depends on and propagate only in the presence of HBV. HDV causes co-infection or super infection with sever complication as compared to only HBV infection. No study on molecular level on HDV is available from this region; therefore, the aim of this study was to found out the molecular epidemiology of HDV (as a co-infection with HBV) in different geographical regions of Pakistan.Total 228 HBsAg positive samples were received for the study from different geographical regions of the country. Only HBV DNA PCR positive samples were further utilized for the presence of HDV RNA. For this purpose, HDV RNA and HBV DNA was extracted and amplified using reverse transcriptase polymerase chain reaction (RT-PCR), nested PCR and real-time PCR.Out of the total 228 HBsAg positive samples, HBV DNA was detected in total 190 (83.3%) samples belonged to different patients. Of these 190 patients, HDV RNA was observed in 53 (28%) patients. Of the 53 HDV positive cases, 37 (69.8%) were males and 16 (30.2%) were female patients. The percentage of dual infection was found higher significantly (p < 0.05) in male patients as compared to female patients. Total 41 (26.8%) patients were below 40 years and 13 (31.7%) were above 40 years of age. No significant difference was seen in patients with ages above or below 40 years. In the provinces of Sindh, Khyber Pakhtoonkhaw and Punjab the observed prevalence of HDV was 67%, 6% and 4% respectively.In conclusion, the HDV infection is not uncommon in Pakistan and its prevalence is higher significantly in the Province of Sindh (p < 0.01) and male six (p < 0.05).
Highlights
Hepatitis Delta virus (HDV) infection is present globally and infects human being already infected by Hepatitis B virus (HBV)
It has been estimated that approximately 5% of HBV carriers are co-infected with HDV, leading to an estimated 15 million persons infected with HDV worldwide [9]
Total 98 patients samples were excluded from the study either the volume of sera were not sufficient for testing (n = 19) or failed to meet inclusion criteria of the study (n = 79) as they were HBV DNA negative by real-time PCR
Summary
Hepatitis Delta virus (HDV) infection is present globally and infects human being already infected by Hepatitis B virus (HBV). Hepatitis Delta is mostly present in Africa; South America, Romania, Russia and the Mediterranean region included Southern Italy [1]. HDV was first discovered by Rizzetto in the patients that were already infected by HBV in year 1980 [2]. Tthe particle size of HDV is about 36-nm that require hepatitis B surface antigen (HBsAg) for their enveloped and transmission [4]. HDV infection has a worldwide distribution, but its frequency varies greatly throughout different geographic regions. It is highly endemic in the Middle East, in the Mediterranean area, in the Amazonian region, and in several African countries [10]
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