Evidence of Hepatitis D Virus Infection in HBsAg Positive Subjects of Mashhad, North-East of Iran

authors:

avatar Hosain Nomanee 1 , avatar Sina Rostami 2 , avatar Mohammad Taghi Shakeri 3 , avatar Zahra Meshkat ORCID 1 , *

Antimicrobial Resistance Research Center, Mashhad University of Medical Sciences, Mashhad, IR Iran
Department of Biology, Faculty of Sciences, Ferdowsi University of Mashhad, Mashhad, IR Iran
Department of Biostatistics, Public Health School, Mashhad University of Medical Sciences, Mashhad, IR Iran

how to cite: Nomanee H, Rostami S, Taghi Shakeri M, Meshkat Z. Evidence of Hepatitis D Virus Infection in HBsAg Positive Subjects of Mashhad, North-East of Iran. Jundishapur J Microbiol. 2015;8(10):e7214. https://doi.org/10.5812/jjm.7214.

Dear Editor,

Anti-Hepatitis D Virus (HDV) among hepatitis B virus surface antigen (HBsAg) positive subjects has been reported from various countries such as Romania (1), Russia (2), Bangladesh (3), Pakistan (4), Saudi Arabia (5), Italy (6), and Mexico (7) with a prevalence of 83.3%, 12.5%, 24.4%, 16.6%, 8.6%, 8.3%, and 4%, respectively. According to studies carried out in Iran, HDV does not have a similar prevalence in different parts of the country. While the overall prevalence seems to have declined in Iran, studies demonstrated an upward trend of HDV infection prevalence among HBsAg-positive patients (8). As described previously, of 3198 individuals enrolled in this study, 34 were HBsAg positive (9). None of HBsAg-positive subjects were positive for anti-HDV.

Similar studies have been carried out in different parts of Iran and different prevalence rates have been reported. A study in Tehran, reported that HDV prevalence rate among Hepatitis B Virus (HBV) infected patients was 12.6% (10). Yaghob et al. observed HDV positivity in 2.2% of HBsAg blood donors in Shahrekord, West of Iran (11). In Golestan province, the prevalence was reported to be 5.8% (12). One study even noted a prevalence of 10.7% in Kerman (13), which is among one of the highest prevalence rates in Iran. In Tehran, capital of Iran, Rezvan et al. (14) noted anti-HDV Ab in 2.4% of HBsAg positive blood donors. According to previous studies in Iran, risk factors for becoming infected with HDV includes surgery, dentistry interventions, endoscopy, tattooing, war injury, traditional phlebotomy (Hejamat), and family history (15).

In our study, none of the HBsAg-positive subjects had positive results for anti-HDV. Since vaccination against HBV can also protect against HDV infection, the data of this study confirms the notion that expanded HBV vaccination coverage in our region might limit the spread of HDV in the normal population. Since HDV infection among HBV carriers could not be prevented unless by educating individuals to prevent further exposures, preventive measures such as vaccination against HBV is necessary but not sufficient for decreasing the prevalence (16). Further investigations with larger sample sizes seem essential to clarify risk factors and prevalence rates in our region.

Acknowledgements

References

  • 1.

    Tapalaga D, Forzani B, Hele C, Paravacini O, Ponzetto A, Theilmann L. Prevalence of the hepatitis delta virus in Rumania. Hepatogastroenterology. 1986;33(6):238-9. [PubMed ID: 3804180].

  • 2.

    Ivaniushina VA, Ryzhova EV, Grudinin MP, Katorgina LG, Nikonova AN, Vinogradova EN, et al. [The frequency of antibodies against delta virus in patients with HBs positive hepatitis]. Vopr Virusol. 1996;41(4):166-9. [PubMed ID: 8999671].

  • 3.

    Zaki H, Darmstadt GL, Baten A, Ahsan CR, Saha SK. Seroepidemiology of hepatitis B and delta virus infections in Bangladesh. J Trop Pediatr. 2003;49(6):371-4. [PubMed ID: 14725415].

  • 4.

    Mumtaz K, Hamid SS, Adil S, Afaq A, Islam M, Abid S, et al. Epidemiology and clinical pattern of hepatitis delta virus infection in Pakistan. J Gastroenterol Hepatol. 2005;20(10):1503-7. [PubMed ID: 16174065]. https://doi.org/10.1111/j.1440-1746.2005.03857.x.

  • 5.

    Al-Traif I, Ali A, Dafalla M, Al-Tamimi W, Qassem L. Prevalence of hepatitis delta antibody among HBsAG carriers in Saudi Arabia. Ann Saudi Med. 2004;24(5):343-4. [PubMed ID: 15573844].

  • 6.

    Gaeta GB, Stroffolini T, Chiaramonte M, Ascione T, Stornaiuolo G, Lobello S, et al. Chronic hepatitis D: a vanishing Disease? An Italian multicenter study. Hepatology. 2000;32(4 Pt 1):824-7. [PubMed ID: 11003629]. https://doi.org/10.1053/jhep.2000.17711.

  • 7.

    Munoz Espinosa LE, Ibarra Salas MJ. [Prevalence of hepatitis D in a population of Northeast Mexico and its relationship with other viruses]. Rev Gastroenterol Mex. 1997;62(4):246-9. [PubMed ID: 9580232].

  • 8.

    Shahinsaz L, Sabahi F, Karimi M, Behzadian F, Alavian SM, Zand V. Detection and genotyping of hepatitis D virus from HBsAg positive patients in Iran using RT-PCR. Iran J Biotech. 2006;4(3):174-9.

  • 9.

    Shakeri MT, Foghanian B, Nomani H, Ghayour-Mobarhan M, Nabavinia MS, Rostami S, et al. The prevalence of hepatitis B virus infection in Mashhad, Iran: a population-based study. Red Crescent Med J. 2013;15(3):245-8.

  • 10.

    Foroutan H, Nemati A, Nasiri-Tosi M, Ghofrani H, Keivani H. Prevalence of hepatitis delta virus infection in various groups with HBVinfection in Tehran, Imam Khomeini Hospital (2005-2006). Med J Islam Repub Iran. 2008;22(2):93-7.

  • 11.

    Yaghob R, Momeni M, Tajbakhsh F, Hamedi S. Serological survey of HDV-Ab in HBsAg positive blood donors in Shahrekord, Iran. Afr J Microbiol. 2011;5(10):1243-5.

  • 12.

    Roshandel G, Semnani S, Abdolahi N, Keshtkar AA, Besharat S, Joshaghani H, et al. Prevalence of hepatitis D virus infection in HBsAg positive subjects in Iran. Pak J Biol Sci. 2007;10(10):1751-4. [PubMed ID: 19086531].

  • 13.

    Zahedi M, Darvish-Moghaddam S, Zareei H. Clinical Impact and Frequency of Hepatitis D Virus Infection in HBsAg Positive Patients in a Southern Province of Iran (Kerman). Iran J Virol. 2010;3(2):1-6.

  • 14.

    Rezvan H, Forouzandeh B, Taroyan S, Fadaiee S, Azordegan F. A study on delta virus infection and its clinical impact in Iran. Infection. 1990;18(1):26-8. [PubMed ID: 2155876].

  • 15.

    Alavian SM, Alavian SH. Hepatitis D virus infection; Iran, Middle East and Central Asia. Hepat Mon. 2005;5(4):137.

  • 16.

    Abbas Z, Jafri W, Raza S. Hepatitis D: Scenario in the Asia-Pacific region. World J Gastroenterol. 2010;16(5):554-62. [PubMed ID: 20128022].