Prevalence and Predictors of Viral Hepatitis D Co-Infection in Chronic HbsAg Carriers

Abstract

The characteristics of viral hepatitis B and D co-infection are poorly documented in Chad. The aim of our study was to determine the prevalence of HBV/HDV co-infection and the characteristics of this co-infection. Materials and Methods: This was a retrospective study including all patients with chronic HBsAg carriers referred in our department from January 2014 to December 2018. Non-inclusion criteria were: absence of anti-HDV testing, presence of anti-viral hepatitis C or Human Immunodeficiency Virus antibodies or excessive alcohol consumption. The variables studied were age, sex, blood transaminase level, HBV DNA level, HDV RNA level, and liver fibrosis and activity score (Actitest Fibrotest). The prevalence of HDV and the characteristics of HDV/HBV co-infection were determined. Results: During the study period, 403 patients were seen in these two hospitals for chronic HBsAg carriage. Of these, 378 (75%) had performed the anti HDV assay. Anti-HDV antibodies were positive in 53 patients (14%). In multivariate analysis, HBV/HDV co-infected patients were less frequently HBeAg positive (5.4% vs. 28.1%; p = 0.0001), older (35 years vs. 32 years; p = 0.001), and more frequently had significant necrotic-inflammatory activity (3.9% vs. 3.2%; p = 0.031) compared with mono infected patients. Neither gender (76.9% male vs. 77.4% male; p = ns), nor viral load (median 530 IU/ml vs. 195 IU/ml; p = ns), nor significant liver fibrosis (35.1% vs. 47.1%; p = ns), nor transaminases (median 26 vs. 32 IU/ml) were different with mono infected patients. Conclusion: VHD is common in Chad. It is associated with increased hepatic necrotic-inflammatory activity.