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Le Guillou-Guillemette H, Pivert A, ElBara A, Vall M, Sang CNW, Veillon P, Ducancelle A, Bollahi MA, Mohamed MS, Lunel-Fabiani F. Prevalence, clinical and virological characteristics and short-term prognosis of hepatitis delta infection among patients with HIV/HBV in Nouakchott, Mauritania. J Viral Hepat 2024; 31:457-465. [PMID: 38771311 DOI: 10.1111/jvh.13950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 04/24/2024] [Accepted: 04/29/2024] [Indexed: 05/22/2024]
Abstract
Patients living with HIV infection (PLWH) are at risk of acquiring HBV and HDV. The present study aimed to determine the prevalence and characteristics of HIV-HDV-HBV tri-infection in comparison with HIV-HBV coinfection and to estimate severities and outcomes of associated liver diseases in Mauritanian PLWH. Two-hundred-ninety-two consecutive HBsAg-positive PLWH were included (mean age: 37 years). Clinical data were recorded. Anti-HDV antibodies, HBV and HDV viral loads (VLs) and genotype were determined. APRI, FIB-4 and FibroScan were performed to evaluate the severity of liver disease. The anti-HDV antibodies prevalence was 37% and HDV RNA was positive in 40.7% of patients. Genetic diversities were found with HDV genotype 1 (93%) and HBV genotypes D (42.5%) and E (38%). The HBV VL was detectable in 108 patients at inclusion, and mutations associated with HBV resistance were found in 20. For almost all variables studied, including FIB-4 and APRI scores, no significant differences were found between anti-HDV-Ab positive or negative patients. FibroScan examination, which was performed in 110 patients at end-of-follow-up showed higher, but NS values, in HDV positive patients. After a mean follow-up of 24.55 ± 8.01 months (n = 217 patients), a highly significant worsening of APRI and FIB-4 scores was found. Moreover, patients with HDV showed more severe liver disease progression despite an efficient therapy. In a substantial Mauritanian cohort of relatively young PLWH, we found high HDV prevalence and worsening liver disease. In high-risk countries, screening for HDV and providing appropriate follow-up and treatments are warranted in PLWH.
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Affiliation(s)
- Hélène Le Guillou-Guillemette
- Virology Department, Angers University Hospital, Angers, France
- HIFIH Laboratory EA 3859, Angers University, Angers, France
| | - Adeline Pivert
- Virology Department, Angers University Hospital, Angers, France
- HIFIH Laboratory EA 3859, Angers University, Angers, France
| | | | | | | | - Pascal Veillon
- Virology Department, Angers University Hospital, Angers, France
| | - Alexandra Ducancelle
- Virology Department, Angers University Hospital, Angers, France
- HIFIH Laboratory EA 3859, Angers University, Angers, France
| | | | | | - Françoise Lunel-Fabiani
- Virology Department, Angers University Hospital, Angers, France
- HIFIH Laboratory EA 3859, Angers University, Angers, France
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Schinas G, Antonopoulou N, Vamvakopoulou S, Tsachouridou O, Protopapas K, Petrakis V, Petrakis EC, Papageorgiou D, Metallidis S, Papadopoulos A, Barbounakis E, Kofteridis D, Panagopoulos P, Lekkou A, Paliogianni F, Akinosoglou K. Prevalence of Hepatitis D in People Living with HIV: A National Cross-Sectional Pilot Study. Viruses 2024; 16:1044. [PMID: 39066206 PMCID: PMC11281684 DOI: 10.3390/v16071044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Revised: 06/24/2024] [Accepted: 06/26/2024] [Indexed: 07/28/2024] Open
Abstract
This study assesses the prevalence of hepatitis D virus (HDV) in people living with HIV (PLWHIV) in Greece. Given the compounding effects of HDV and hepatitis B (HBV) on liver disease progression, as well as the emergence of new therapeutic options such as bulevirtide, understanding regional disparities and the epidemiological impact of such co-infections is vital. A cross-sectional analysis was conducted utilizing 696 serum samples from PLWHIV attending five major university hospitals. The methodology included HDV antibody detection by ELISA and HDV RNA confirmation. Of the 30 HBsAg-positive samples analyzed, the study population was primarily male (93%), with a median age of 54 years. Participants had been on antiretroviral therapy for a median of 10 years, and the median CD4 count was 738 (539-1006) copies/mL. Additional serological findings revealed a 7% prevalence of hepatitis C virus (HCV) IgG antibodies and a 55% prevalence of hepatitis A virus (HAV) IgG antibodies. Seroreactivity for syphilis (RPR/VDRL/TPHA positive) was identified in 33% of the participants. The results indicated a low HDV prevalence, with only one individual (3%) testing positive for anti-HDV IgG antibodies and none for HDV RNA. This indicates a lower prevalence of HDV among PLWHIV with chronic HBV in Greece compared to global data.
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Affiliation(s)
- Georgios Schinas
- School of Medicine, University of Patras, 26504 Patras, Greece; (G.S.); (N.A.); (D.P.)
| | - Nikolina Antonopoulou
- School of Medicine, University of Patras, 26504 Patras, Greece; (G.S.); (N.A.); (D.P.)
| | - Sofia Vamvakopoulou
- Department of Microbiology, University General Hospital of Patras, 26504 Patras, Greece (F.P.)
| | - Olga Tsachouridou
- Departments of Internal Medicine and Infectious Diseases, University General Hospital of Thessaloniki “AHEPA”, 54636 Thessaloniki, Greece; (O.T.); (S.M.)
| | - Konstantinos Protopapas
- 4th Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Attikon University General Hospital, 12462 Athens, Greece; (K.P.); (A.P.)
| | - Vasileios Petrakis
- Departments of Internal Medicine and Infectious Diseases, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (V.P.); (P.P.)
| | - Emmanouil C. Petrakis
- Departments of Internal Medicine and Infectious Diseases, University General Hospital of Heraklion, 71500 Heraklion, Greece; (E.C.P.); (E.B.); (D.K.)
| | - Despoina Papageorgiou
- School of Medicine, University of Patras, 26504 Patras, Greece; (G.S.); (N.A.); (D.P.)
| | - Simeon Metallidis
- Departments of Internal Medicine and Infectious Diseases, University General Hospital of Thessaloniki “AHEPA”, 54636 Thessaloniki, Greece; (O.T.); (S.M.)
| | - Antonios Papadopoulos
- 4th Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Attikon University General Hospital, 12462 Athens, Greece; (K.P.); (A.P.)
| | - Emmanouil Barbounakis
- Departments of Internal Medicine and Infectious Diseases, University General Hospital of Heraklion, 71500 Heraklion, Greece; (E.C.P.); (E.B.); (D.K.)
| | - Diamantis Kofteridis
- Departments of Internal Medicine and Infectious Diseases, University General Hospital of Heraklion, 71500 Heraklion, Greece; (E.C.P.); (E.B.); (D.K.)
| | - Periklis Panagopoulos
- Departments of Internal Medicine and Infectious Diseases, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (V.P.); (P.P.)
| | - Alexandra Lekkou
- Departments of Internal Medicine and Infectious Diseases, University General Hospital of Patras, 26504 Patras, Greece;
| | - Fotini Paliogianni
- Department of Microbiology, University General Hospital of Patras, 26504 Patras, Greece (F.P.)
| | - Karolina Akinosoglou
- School of Medicine, University of Patras, 26504 Patras, Greece; (G.S.); (N.A.); (D.P.)
- Departments of Internal Medicine and Infectious Diseases, University General Hospital of Patras, 26504 Patras, Greece;
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Ferrante ND, Kallan MJ, Sukkestad S, Kodani M, Kitahata MM, Cachay ER, Bhattacharya D, Heath S, Napravnik S, Moore RD, Yendewa G, Mayer KH, Reddy KR, Hayden T, Kamili S, Martin JN, Kim HN, Lo Re V. Prevalence and determinants of hepatitis delta virus infection among HIV/hepatitis B-coinfected adults in care in the United States. J Viral Hepat 2023; 30:879-888. [PMID: 37488783 PMCID: PMC10592429 DOI: 10.1111/jvh.13874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 07/07/2023] [Indexed: 07/26/2023]
Abstract
Hepatitis delta virus (HDV) infection increases the risk of liver complications compared to hepatitis B virus (HBV) alone, particularly among persons with human immunodeficiency virus (HIV). However, no studies have evaluated the prevalence or determinants of HDV infection among people with HIV/HBV in the US. We performed a cross-sectional study among adults with HIV/HBV coinfection receiving care at eight sites within the Center for AIDS Research Network of Integrated Clinical Systems (CNICS) between 1996 and 2019. Among patients with available serum/plasma specimens, we selected the first specimen on or after their initial HBV qualifying test. All samples were tested for HDV IgG antibody and HDV RNA. Multivariable log-binomial generalized linear models were used to estimate prevalence ratios (PRs) with 95% CIs of HDV IgG antibody-positivity associated with determinants of interest (age, injection drug use [IDU], high-risk sexual behaviour). Among 597 adults with HIV/HBV coinfection in CNICS and available serum/plasma samples (median age, 43 years; 89.9% male; 52.8% Black; 42.4% White), 24/597 (4.0%; 95% CI, 2.4%-5.6%) were HDV IgG antibody-positive, and 10/596 (1.7%; 95% CI, 0.6%-2.7%) had detectable HDV RNA. In multivariable analysis, IDU was associated with exposure to HDV infection (adjusted PR = 2.50; 95% CI, 1.09-5.74). In conclusion, among a sample of adults with HIV/HBV coinfection in care in the US, 4.0% were HDV IgG antibody-positive, among whom 41.7% had detectable HDV RNA. History of IDU was associated with exposure to HDV infection. These findings emphasize the importance of HDV testing among persons with HIV/HBV coinfection, especially those with a history of IDU.
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Affiliation(s)
- Nicole D. Ferrante
- Division of Gastroenterology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
- Department of Biostatistics, Epidemiology, and Informatics, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA
| | - Michael J. Kallan
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Sophia Sukkestad
- Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, GA
| | - Maja Kodani
- Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, GA
| | - Mari M. Kitahata
- Division of Allergy and Infectious Disease, Department of Medicine, University of Washington School of Medicine, Seattle, WA
| | - Edward R. Cachay
- Department of Medicine, Division of Infectious Diseases and Global Public Health University of California, San Diego, CA
| | - Debika Bhattacharya
- Department of Medicine, Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, CA
| | - Sonya Heath
- Division of Infectious Disease, Department of Medicine, University of Alabama, Birmingham, AL
| | - Sonia Napravnik
- Department of Medicine, University of North Carolina, Chapel Hill, NC
| | - Richard D. Moore
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University, Baltimore, MD
| | - George Yendewa
- Department of Medicine, Case Western Reserve University, Cleveland, OH
| | - Kenneth H. Mayer
- The Fenway Institute, Fenway Health, Boston, MA; Department of Medicine, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA
| | - K. Rajender Reddy
- Division of Gastroenterology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Tonya Hayden
- Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, GA
| | - Saleem Kamili
- Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, GA
| | - Jeffrey N. Martin
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA
| | - H. Nina Kim
- Division of Allergy and Infectious Disease, Department of Medicine, University of Washington School of Medicine, Seattle, WA
| | - Vincent Lo Re
- Department of Biostatistics, Epidemiology, and Informatics, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA
- Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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Visco Comandini U, De Santis E, De Maria F, Lionetti R, Taibi C, Montalbano M, Rianda A, Piccolo P, De Ponte C, Mazzotta S, Caioli A, Garbuglia AR, Maggi F, D'Offizi G. "Real world" efficacy of bulevirtide in HBV/HDV-related cirrhosis including people living with HIV: Results from the compassionate use programme at INMI Spallanzani in Rome, Italy. HIV Med 2023; 24:1075-1082. [PMID: 37287427 DOI: 10.1111/hiv.13518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 05/17/2023] [Indexed: 06/09/2023]
Abstract
OBJECTIVES We describe the preliminary results of bulevirtide compassionate use in patients with hepatitis B and delta virus (HBV/HDV)-related cirrhosis and clinically significant portal hypertension, including those living with HIV. METHODS We conducted a prospective observational study of consecutive patients. Clinical evaluation, liver function tests, bile acid levels, HDV-RNA, HBV-DNA, hepatitis B surface antigen, and liver and spleen stiffness were assessed at baseline and after treatment months 1, 2, 3, 4, 6, 9, and 12. HIV-RNA and CD4+/CD8+ count were assessed in people living with HIV. The first drug injection was administered under nurse supervision, and counselling was provided and adherence reviewed at each visit. RESULTS In total, 13 patients (61.5% migrants) were enrolled. The median treatment duration was 11 months. At month 6, mean alanine aminotransferase (ALT) levels fell by 64.5% and mean liver and spleen stiffness decreased by 8.6 and 0.9 kPa, respectively. The mean baseline HDV-RNA was 3.34 log IU/mL and 5.10 log IU/mL in people without and with HIV (n = 5) (p = 0.28), respectively. A similar mean decline was observed in both groups: -2.06 log IU/mL and -1.93 log IU/mL, respectively (p = 0.87). A combined response (undetectable HDV RNA or ≥ -2 log IU/mL decline vs. baseline, with ALT normalization) was achieved in 66% of subjects without and in 60% of patients with HIV. Patients with HIV showed persistently undetectable HIV-RNA and a progressive increase in CD4+/CD8+ cells during treatment. No patient discontinued bulevirtide because of adverse effects. CONCLUSIONS Preliminary results suggest that bulevirtide is feasible and well-tolerated in populations with difficult-to-treat conditions, such as those with HIV/HBV/HDV co-infection and migrants, when special attention is given to patient education. HDV-RNA decline during treatment was similar in people living with and without HIV.
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Affiliation(s)
- Ubaldo Visco Comandini
- Infectious Diseases and Hepatology Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Rome, Italy
| | - Emanuela De Santis
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Francesco De Maria
- Infectious Diseases and Hepatology Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Rome, Italy
| | - Raffaella Lionetti
- Infectious Diseases and Hepatology Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Rome, Italy
| | - Chiara Taibi
- Infectious Diseases and Hepatology Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Rome, Italy
| | - Marzia Montalbano
- Infectious Diseases and Hepatology Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Rome, Italy
| | - Alessia Rianda
- Infectious Diseases and Hepatology Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Rome, Italy
| | - Paola Piccolo
- Internal Medicine Unit, Fatebenefratelli Isola Tiberina Hospital-Gemelli Isola, Rome, Italy
| | - Chiara De Ponte
- Pharmacy Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Rome, Italy
| | - Stefania Mazzotta
- Pharmacy Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Rome, Italy
| | - Alessandro Caioli
- Infectious Diseases and Hepatology Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Rome, Italy
| | - Anna Rosa Garbuglia
- Virology Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Rome, Italy
| | - Fabrizio Maggi
- Virology Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Rome, Italy
| | - Gianpiero D'Offizi
- Infectious Diseases and Hepatology Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Rome, Italy
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