Hepatitis D in Chronic Active Hepatitis B: Prevalence, Liver Enzyme Levels and Histopathology- an Epidemiological Study in Shiraz, Southern Iran, 2003-2004

Background and Aims: At least 5% of hepatitis B carriers worldwide are infected with Hepatitis D virus (HDV). This study aims to determine the prevalence, transaminase levels and histopathological findings of HDV among patients with chronic active hepatitis B in southern Iran.

Methods: During 2003-2004, 93 patients >15 years with chronic active hepatitis B were enrolled from referrals to Shiraz University of Medical Sciences in southern Iran.

Results: Nine (9.7%) patients were seropositive for the anti HDV antibody. 76.3% of patients were male and among the HDV positive group, all subjects were male too. A significantly higher AST and more advanced grade and stage of liver disease were observed in the HDV positive group. The most common mode of transmission in the positive group was intravenous drug use.

Conclusions: The risk of liver disease progression in chronic hepatitis B appears to be higher in HDV infected patients. Intravenous drug abuse is an important risk factor for acquiring HDV infection. Checking anti-HDV is suggested in any patient with positive HBsAg, especially in males or those with history of intravenous drug abuse.