Seroprevalence of HDV among non-hospitalized HBsAg positive patients from KPK-region of Pakistan

Abstract

Objective: To study the seroprevalence of hepatitis B virus (HBV) and hepatitis delta virus (HDV) infections in patients visiting outpatient department of a major tertiary care hospital in Khyber Pakhtunkhwa region of Pakistan. Methods: Blood samples were collected from non-hospitalized patients. Serological analysis was done by ELISA and viral DNA was amplified by PCR. The amplified DNA was analyzed by agarose gel electrophoresis. Results: Altogether, 946 blood samples were screened, overall percentage of HBsAg-positive patients remained 22.41% (prevalence: 224.10/1000; CI: 0.1975 ± 0.2507) with the highest incidence rates among relatively younger age groups (20–29 years). The prevalence of HBV–HDV co-infection was found to be 46.75/1000; CI: 0.0318 ± 0.0617. In HBsAg-positive patients, anti-HBc-total was detected in 86.79% while 25.00% were positive for anti-HBc-immunoglobulin M. Similarly, among these patients, HBV DNA was detected in 64.13% and 10.85% were co-infected with HDV. Different symptoms were associated with the prevailing infection, including malaise (62%), anorexia (66%) and fatigue (73%). The most commonly associated symptom was abdominal discomfort. Among these patients, certain risk factors, including surgery, visit to dentist and intravenus infusions were frequently associated with the infection (χ2 = 95.23; df = 11; P < 0.0001). Conclusions: Overall, this study confirmed higher prevalence of active HBV/HDV infection, among young patients from Khyber Pakhtunkhwa region having no prior history of viral hepatitis.

Keywords

• HBV
• HCV
• HDV
• Risk factors
• Co-infection