Frequency of Hepatitis D Viral Infection in Chronic Hepatitis B Patients in Pakistan
Frequency of Hepatitis D Viral Infection in Chronic Hepatitis B Patients in Pakistan
Samia Afzal1*, Jahanzaib Ahmad1, Iram Amin1, Liaqat Ali2, Muhammad Shahid1, Mohsin Ahmad Khan1 and Muhammad Idrees1
ABSTRACT
Hepatitis Delta Virus (HDV) is a satellite virus of hepatitis B virus (HBV) as HDV relies on hepatitis B surface antigen (HBsAg) for viral development and release from hepatocytes. It causes the most severe viral hepatitis and suppresses the serological and molecular markers of HBV infections; for example, Hepatitis B envelope antigen (HBeAg), inhibition and reduction of HBV DNA titer during HDV infections. Very few studies described the clampdown of HBV-related markers during HDV replication and the current study is the only report from Pakistani perspective. The objective of this study is to find the interference of HDV in HBV replication, both in HBV chronic active and inactive state patients from four different a Pakistani provinces. Blood samples along with patient history and demographic data were collected from 100 (n=100) patients, all of these were positive for HBsAg (further characterized as acute or chronic hepatitis B). Viral titer was quantified from the HBsAg positive samples by real time-PCR, HBeAg by ELISA, and HDV RNA was detected by nested PCR and sequencing. HBV DNA was detected in 58% of the samples. The quantification of viral load revealed chronic active HBV infection at 11% and chronic inactive HBV infection as 63%. HDV RNA was present in 41.2 % of inactive chronic HBV carriers and only 18.1% in active HBV-infected patients. I has been observed that the presence of HDV infection may suppress the HBV replication and convert it into an inactive state and the overall prevalence of HDV in Pakistan is 35% in HBV-positive patients.
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