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Prevalence of Hepatitis D in HbsAg Positive Patients Visiting the Liver Clinics in Pakistan

2008; Lippincott Williams & Wilkins; Volume: 103; Linguagem: Inglês

10.14309/00000434-200809001-00360

1572-0241

Naresh Kumar Seetlani, Zaigham Abbas, Sajjad Naqvi, Javed Yakoob, Wasim Jafri,

Liver Disease Diagnosis and Treatment

Purpose: There is a global decline in the prevalence of hepatitis D infection. However there are still pockets of high prevalence in Pakistan. The aim of our study was to estimate the prevalence of hepatitis D in HBsAg (hepatitis B surface antigen) positive patients visiting liver clinics. Methods: The patients who visited the two liver clinics, one in Karachi and the other in Jacobabad, from October 2007 to March 2008, having positive HBsAg, were included in the study. These patients were screened for HBeAg, HBV DNA by PCR, anti-HDV and HDV RNA by PCR. Clinical status of the patients was evaluated by examination, routine biochemical tests and ultrasound. Results: Total numbers of patients included in the study were 362 comprising of 151 patients from the clinic in Jacobabad and 211 from Karachi. The patients ranged from 4 to 70 years of age (mean age 29.75 ± 11.27). Out of the total patients 297 (82%) were male. Ninety seven (26.8%) were the residents of Jacobabad, 82 (22.7%) of Karachi, 55 (15.2%) Jaffarabad, 35 (9.7%) Naseerabad, 26 (7.2%) Kashmore, 23 (6.4%) Quetta and remaining from the other parts of the country mainly from the provinces of Sindh and Balochistan. All the patients were screened for HDV antibody out of which 212 (58.6%) tested positive for the antibody. Total 65 anti-HDV positive patients were screened for the HDV RNA by PCR out of which 30 (46.2%) tested positive for the virus. Three hundred and forty (340) patients were screened for HBeAg out of which 71 (20.9%) tested positive for HBeAg. Three hundred and seven patients were screened for HBV DNA by PCR out of which 88 (28.7%) tested positive for the virus. The frequency of positive HDV antibody was 69.23% in Kashmore, 67% in Jacobabad, 65.4% in Jaffarabad, 65.21% in Quetta, 60% in Naseerabad, 36.58% in Karachi, 58.33% in other areas of Balochistan and 60.71% in other areas of Sindh. Conclusion: This data show extremely high prevalence of hepatitis D in the referred patients from some pockets of Southern Pakistan. Effective preventive measures are the need of time. Pakistan may be considered as the area of highest HDV prevalence around the globe.