PREVALENCE OF HEPATITIS D VIRUS AND ITS IMPACT ON CLINICAL PARAMETERS IN QUETTA, PAKISTAN

Main Article Content

Akhtar Hamid Tariq
Tauseef M Asmat
Mohammad Zahid Mustafa
Shahid Pervaz

Keywords

Abstract

Background and Objectives: Hepatitis delta virus (HDV) is a small, 1.7 Kb RNA virus contained in a protein envelope consisting of hepatitis B surface antigen (HbsAg). Hepatitis delta has a worldwide distribution and is often attributed to cause severe and progressive liver disease. HDV infection in Quetta has been reported previously but no comprehensive study is available. The aim of this study was to get first detailed insight of HDV infections and associated risk factors in infected patients.                                                                       


Methods: It was a cross sectional study. The study was conducted in Balochistan from 2021-22 All the HbsAg positive patients visiting tertiary care hospitals in Quetta were included in the study. The collected blood samples with elevated liver function tests were screened for the detection of HbsAg anti-HDV and anti-HCV. ELISA and qPCR were employed for confirmation and quantification. The collected data was recorded in MS-excel and the standard descriptive analysis was done by using MS-excel and SPSS V20.                                 


Results: The present study showed that 27 participants were tested positive for HDV PCR out of 138 positive HbsAg PCR patients. HbsAg PCR was found to have a significant association with the gender. Similarly, LFT Alkaline Phosphatase, Heamoglobin Levels and WBC Levels were also found to have a significant association with the gender.  It was also noted that LFT bilirubin of 133 participants was found increased, LFT SGPT of 284 participants was found increased, 281 participants had increased levels of LFT Alkaline phosphatase, 276 participants had increased LFT y-GT whereas 130 participants were reported with enlarged liver through ultrasound.


 Conclusion: This study concludes that every fifth HbsAg positive patients is vulnerable to the development of hepatitis in Quetta, Pakistan.

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References

1. Gerin, J.L., J.L. Casey, and K.F. Bergmann. The molecular biology of hepatitis delta virus: recent advances. in Viral Hepatitis and Liver Disease: Proceedings of the International Symposium on Viral Hepatitis and Liver Disease: Molecules Today, More Cures Tomorrow, Tokyo, May 10–14, 1993 (1993 ISVHLD). 1994. Springer.
2. Purcell, R.H., The discovery of the hepatitis viruses. Gastroenterology, 1993. 104(4): p. 955-963.
3. Rizzetto, M., R. Purcell, and J. Gerin, Epidemiology of HBV-associated delta agent: geographical distribution of anti-delta and prevalence in polytransfused HbsAg carriers. The Lancet, 1980. 315(8180): p. 1215-1219.
4. Cotrina, M., et al., Hepatitis delta genotypes in chronic delta infection in the northeast of Spain (Catalonia). Journal of hepatology, 1998. 28(6): p. 971-977.
5. Rishi, Z.I., M.A.M. KashifMalik, and M. Yousaf, High Rates of Hepatitis Delta Virus Superinfection I Co infection in Balochistan. Proceeding SZPGMI vol, 2007. 21(1): p. 1-4.
6. Sheikh, N.S., et al., Sero-prevalence of hepatitis B virus infection in Balochistan Province of Pakistan. Saudi Journal of Gastroenterology, 2011. 17(3): p. 180-184.
7. Smedile, A., et al., Epidemiologic patterns of infection with the hepatitis B virus-associated delta agent in Italy. American journal of epidemiology, 1983. 117(2): p. 223-229.
8. Sagnelli, E., et al., Decrease in HDV endemicity in Italy. Journal of hepatology, 1997. 26(1): p. 20-24.
9. Navascués, C.A., et al., Epidemiology of hepatitis D virus infection: changes in the last 14 years. American Journal of Gastroenterology (Springer Nature), 1995. 90(11).
10. Mumtaz, K., et al., Epidemiology and clinical pattern of hepatitis delta virus infection in Pakistan. Journal of gastroenterology and hepatology, 2005. 20(10): p. 1503-1507.
11. Nguyen, H.M., et al., Prevalence and genotype distribution of hepatitis delta virus among chronic hepatitis B carriers in Central Vietnam. PLoS One, 2017. 12(4): p. e0175304.
12. SAKUGAWA, H., et al., Seroepidemiological study on hepatitis delta virus infection in the Irabu Islands, Okinawa, Japan. Journal of gastroenterology and hepatology, 1997. 12(4): p. 299-304.
13. Luby, S., et al., The relationship between therapeutic injections and high prevalence of hepatitis C infection in Hafizabad, Pakistan. Epidemiology & Infection, 1997. 119(3): p. 349-356.
14. Din, G., et al., Prevalence of hepatitis C virus infection among thalassemia patients: a perspective from a multi-ethnic population of Pakistan. Asian Pacific journal of tropical medicine, 2014. 7: p. S127-S133.
15. Alavian, S., Hepatitis D Virus Infection; Iran, Middle East and Central Asia. Hepatitis Monthly, 2005. 5(4): p. 137-143.
16. Sureau, C. and F. Negro, The hepatitis delta virus: Replication and pathogenesis. Journal of hepatology, 2016. 64(1): p. S102-S116.
17. Chen, P.-J., et al., δ Infection in asymptomatic carriers of hepatitis B surface antigen: Low prevalence of δ activity and effective suppression of hepatitis B virus replication. Hepatology, 1988. 8(5): p. 1121-1124.
18. Wu, J.C., et al., Production of hepatitis delta virus and suppression of helper hepatitis B virus in a human hepatoma cell line. Journal of virology, 1991. 65(3): p. 1099-1104.
19. Wedemeyer, H. and M.P. Manns, Epidemiology, pathogenesis and management of hepatitis D: update and challenges ahead. Nature reviews Gastroenterology & hepatology, 2010. 7(1): p. 31-40.
20. Abbas, Z., et al., Hepatocellular carcinoma in hepatitis D: does it differ from hepatitis B monoinfection? Saudi Journal of Gastroenterology, 2012. 18(1): p. 18-22.
21. Moatter, T., et al., Clinical presentation and genotype of hepatitis delta in Karachi. World Journal of Gastroenterology: WJG, 2007. 13(18): p. 2604.
22. Wu, J.-C., et al., Genotyping of hepatitis D virus by restriction-fragment length polymorphism and relation to outcome of hepatitis D. The Lancet, 1995. 346(8980): p. 939-941.
23. Alam, M.M., et al., Molecular epidemiology of Hepatitis B virus genotypes in Pakistan. BMC infectious diseases, 2007. 7: p. 1-6.