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Ndzie Ondigui JL, Mafopa Goumkwa N, Lobe C, Wandji B, Awoumou P, Voussou Djivida P, Peyonga P, Manju Atah S, Verbe V, Kamgaing Simo R, Moudourou SA, Gutierrez A, Garcia R, Fernandez I, Riwom Essama SH, Mbu R, Torimiro J. Prevalence and risk factors of transmission of hepatitis delta virus in pregnant women in the Center Region of Cameroon. PLoS One 2024; 19:e0287491. [PMID: 38900729 PMCID: PMC11189217 DOI: 10.1371/journal.pone.0287491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 03/09/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND Hepatitis B virus (HBV) and hepatitis delta virus (HDV) co-infection has been described as the most severe form of viral hepatitis, and can be co-transmitted from mother-to-child. A seroprevalence of 4.0% of HDV infection was reported in pregnant women in Yaoundé, and 11.9% in the general population in Cameroon. Our objective was to describe the rate of HDV infection in HBsAg-positive pregnant women and to determine risk factors associated with mother-to-child transmission of HDV. MATERIALS AND METHODS A cross-sectional, descriptive study was conducted from January 2019 to July 2022 among pregnant women attending antenatal contacts in seven health structures in the Centre Region of Cameroon. A consecutive sampling (non-probability sampling) was used to select only pregnant women of age over 21 years, who gave a written informed consent. Following an informed consent, an open-ended questionnaire was used for a Knowledge, Attitude and Practice (KAP) survey of these women, and their blood specimens collected and screened for HBsAg, anti-HIV and anti-HCV antibodies by rapid tests and ELISA. HBsAg-positive samples were further screened for HBeAg, anti-HDV, anti-HBs, and anti HBc antibodies by ELISA, and plasma HDV RNA load measured by RT-qPCR. RESULTS Of 1992 pregnant women, a rate of 6.7% of HBsAg (133/1992) with highest rate in the rural areas, and 3.9% of hepatitis vaccination rate were recorded. Of 130, 42 (32.3%) were anti-HDV antibody-positive, and 47.6% had detectable HDV RNA viraemia. Of 44 anti-HDV-positive cases, 2 (4.5%) were co-infected with HBV and HCV, while 5 (11.4%) with HIV and HBV. Multiple pregnancies, the presence of tattoos and/or scarifications were significantly associated with the presence of anti-HDV antibodies. Of note, 80% of women with negative HBeAg and positive anti-HBe serological profile, had plasma HDV RNA load of more than log 3.25 (>10.000 copies/ml). CONCLUSION These results show an intermediate rate of HDV infection among pregnant women with high level of HDV RNA viremia, which suggest an increased risk of vertical and horizontal co-transmission of HDV.
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Affiliation(s)
- Juliette-Laure Ndzie Ondigui
- Faculty of Sciences, Department of Microbiology, University of Yaoundé 1, Yaounde, Cameroon
- Chantal BIYA” International Reference Center for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
| | - Nadège Mafopa Goumkwa
- Chantal BIYA” International Reference Center for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
| | - Cindy Lobe
- Chantal BIYA” International Reference Center for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
- Department of Food Science and Nutrition, National School of Agro-Industrial Sciences, University of Ngaoundere, Ngaoundere, Cameroon
| | - Brigitte Wandji
- Yaoundé Gyanecology Obstetrics and Paediatrics Hospital, Yaounde, Cameroon
| | - Patrick Awoumou
- Chantal BIYA” International Reference Center for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
- Faculty of Medicine and Biomedical Sciences, Department of Biochemistry, University of Yaounde 1, Yaounde, Cameroon
| | - Prisca Voussou Djivida
- Faculty of Medicine and Biomedical Sciences, Department of Biochemistry, University of Yaounde 1, Yaounde, Cameroon
| | - Puinta Peyonga
- Faculty of Medicine and Biomedical Sciences, Department of Biochemistry, University of Yaounde 1, Yaounde, Cameroon
| | - Solange Manju Atah
- Faculty of Medicine and Biomedical Sciences, Department of Public Health, University of Yaounde 1, Yaounde, Cameroon
| | | | - Rachel Kamgaing Simo
- Chantal BIYA” International Reference Center for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
| | - Sylvie Agnès Moudourou
- Chantal BIYA” International Reference Center for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
| | | | - Rosi Garcia
- Bikop Catholic Health Center, Bikop, Cameroon
| | | | | | - Robinson Mbu
- Yaoundé Gyanecology Obstetrics and Paediatrics Hospital, Yaounde, Cameroon
- Faculty of Medicine and Biomedical Sciences, Department of Gynecology/Obstetrics, University of Yaounde 1, Yaounde, Cameroon
| | - Judith Torimiro
- Chantal BIYA” International Reference Center for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
- Faculty of Medicine and Biomedical Sciences, Department of Biochemistry, University of Yaounde 1, Yaounde, Cameroon
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de los Ángeles Rodríguez Lay L, Tan Z, Villalba MCM, Suárez MS, Corredor MB, Hernández DL, Sánchez BM, Alonso LV, Sausy A, Hübschen JM. Low prevalence of hepatitis delta infection in Cuban HBsAg carriers: Prospect for elimination. Front Med (Lausanne) 2023; 9:1069372. [PMID: 36816726 PMCID: PMC9928864 DOI: 10.3389/fmed.2022.1069372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 12/16/2022] [Indexed: 02/04/2023] Open
Abstract
Introduction Infection with hepatitis delta virus (HDV) is one of the most severe hepatitis B virus (HBV) complications, with a more rapid progression to cirrhosis and an increased risk of hepatic decompensation and death. Data on HDV infection in Cuba are limited. The aims of our study were to determine the HDV prevalence in HBsAg carriers and to characterize the HDV strains circulating. The data were used to assess the possibility of HDV elimination in the Cuban HBV epidemiological setting. Methods Five hundred and two serum samples from the same number of HBsAg carriers collected in the period 2006-2019 from all over the country were tested for anti-HDV total antibodies. If positive, the samples were analyzed for HDV-RNA using Real-Time RT-PCR targeting the ribozyme and HD antigen domains followed by genotyping based on phylogenetic analysis. Results Two samples were anti-HDV positive [0.39% (95% CI 0.11-1.44)]. One of them was also HDV-RNA positive. Clinically, the patient with active HDV infection had compensated liver cirrhosis. Phylogenetic analysis showed that the virus belonged to genotype 1 and thus clustered with contemporary strains from North America, Europe, Middle East, and Asia. Discussion This is the first HDV study, including molecular detection and virus characterization, done after the introduction of the universal childhood anti-hepatitis B vaccination. The very low prevalence of HDV infection in HBsAg carriers combined with the high HBV vaccination coverage of all newborn children, of previously identified risk groups, and of the general population currently under 40 years of age suggests that HDV elimination is feasible in Cuba if the success in HBV control is maintained.
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Affiliation(s)
- Licel de los Ángeles Rodríguez Lay
- National Reference Laboratory of Viral Hepatitis, Department of Virology, Institute of Tropical Medicine “Pedro Kourí”, Havana, Cuba,*Correspondence: Licel de los Ángeles Rodríguez Lay, ; orcid.org/0000-0002-7742-3146
| | - Zexi Tan
- National Reference Laboratory of Viral Hepatitis, Department of Virology, Institute of Tropical Medicine “Pedro Kourí”, Havana, Cuba
| | - Maria Caridad Montalvo Villalba
- National Reference Laboratory of Viral Hepatitis, Department of Virology, Institute of Tropical Medicine “Pedro Kourí”, Havana, Cuba
| | | | - Marité Bello Corredor
- National Reference Laboratory of Viral Hepatitis, Department of Virology, Institute of Tropical Medicine “Pedro Kourí”, Havana, Cuba
| | - Dayesi López Hernández
- National Reference Laboratory of Viral Hepatitis, Department of Virology, Institute of Tropical Medicine “Pedro Kourí”, Havana, Cuba
| | - Barbara Marrero Sánchez
- National Reference Laboratory of Viral Hepatitis, Department of Virology, Institute of Tropical Medicine “Pedro Kourí”, Havana, Cuba
| | - Lidunka Valdés Alonso
- National Reference Laboratory of Viral Hepatitis, Department of Virology, Institute of Tropical Medicine “Pedro Kourí”, Havana, Cuba
| | - Aurélie Sausy
- Clinical and Applied Virology Group, Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
| | - Judith M. Hübschen
- Clinical and Applied Virology Group, Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
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Fallon BS, Cooke EM, Hesterman MC, Norseth JS, Akhundjanov SB, Weller ML. A changing landscape: Tracking and analysis of the international HDV epidemiology 1999-2020. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0000790. [PMID: 37098008 PMCID: PMC10129014 DOI: 10.1371/journal.pgph.0000790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 03/09/2023] [Indexed: 04/26/2023]
Abstract
The international epidemiology of Hepatitis Delta Virus (HDV) is challenging to accurately estimate due to limited active surveillance for this rare infectious disease. Prior HDV epidemiological studies have relied on meta-analysis of aggregated and static datasets. These limitations restrict the capacity to actively detect low-level and/or geographically dispersed changes in the incidence of HDV diagnoses. This study was designed to provide a resource to track and analyze the international HDV epidemiology. Datasets analyzed collectively consisted of >700,000 HBV and >9,000 HDV reported cases ranging between 1999-2020. Datasets mined from government publications were identified for Argentina, Australia, Austria, Brazil, Bulgaria, Canada, Finland, Germany, Macao, Netherlands, New Zealand, Norway, Sweden, Taiwan, Thailand, United Kingdom, and United States. Time series analyses, including Mann-Kendall (MK) trend test, Bayesian Information Criterion (BIC), and hierarchal clustering, were performed to characterize trends in the HDV timelines. An aggregated prevalence of 2,560 HDV/HBV100,000 cases (95% CI 180-4940) or 2.56% HDV/HBV cases was identified, ranging from 0.26% in Canada to 20% in the United States. Structural breaks in the timeline of HDV incidence were identified in 2002, 2012, and 2017, with a significant increase occurring between 2013-2017. Significant increasing trends in reported HDV and HBV cases were observed in 47% and 24% of datasets, respectively. Analyses of the HDV incidence timeline identified four distinct temporal clusters, including Cluster I (Macao, Taiwan), Cluster II (Argentina, Brazil, Germany, Thailand), Cluster III (Bulgaria, Netherlands, New Zealand, United Kingdom, United States) and Cluster IV (Australia, Austria, Canada, Finland, Norway, Sweden). Tracking of HDV and HBV cases on an international scale is essential in defining the global impact of viral hepatitis. Significant disruptions of HDV and HBV epidemiology have been identified. Increased surveillance of HDV is warranted to further define the etiology of the recent breakpoints in the international HDV incidence.
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Affiliation(s)
- Braden S Fallon
- School of Dentistry, University of Utah, Salt Lake City, UT, United States of America
| | - Elaine M Cooke
- School of Dentistry, University of Utah, Salt Lake City, UT, United States of America
| | - Matthew C Hesterman
- School of Dentistry, University of Utah, Salt Lake City, UT, United States of America
| | - Jared S Norseth
- School of Dentistry, University of Utah, Salt Lake City, UT, United States of America
| | - Sherzod B Akhundjanov
- Department of Applied Economics, Utah State University, Logan, UT, United States of America
| | - Melodie L Weller
- School of Dentistry, University of Utah, Salt Lake City, UT, United States of America
- Department of Pathology, Division of Microbiology and Immunology, University of Utah, Salt Lake City, UT, United States of America
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From national HBV and HDV screenings to vaccination and treatment in healthcare workers: The Mauritanian pilot study. Vaccine 2021; 39:2274-2279. [PMID: 33752951 DOI: 10.1016/j.vaccine.2021.03.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 02/03/2021] [Accepted: 03/03/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Hepatitis B and D infections are highly endemic in Mauritania, with prevalences ranging from 10 to 20%. With the present prospective transversal pilot study, we aimed to evaluate the prevalences of HBV, HCV, and HDV infections in healthcare workers (HCWs), and offer treatment or vaccination as required. METHODS At inclusion, each HCW was screened for anti-HBc Ab (followed by HBsAg assay when positive). Additional biological analyses were performed for HBsAg + cases. Depending on the results, HBV vaccination or anti-viral treatment was offered. RESULTS A total of 3,857 HCWs were included, of whom 1,363 tested negative for anti-HBc Ab and received full vaccination. Of the 2,494 HCWs who were positive for anti-HBc Ab, 1,246 were positive for anti-HBs Ab and 418 were positive for HBsAg. Three HCWs were positive for HBeAg; 66 and 18 had HBV DNA levels respectively > 2,000 and > 20,000 IU/mL; and 48 were positive for anti-HDV Ab among whom 10 were positive for HDV RNA. HCV prevalence was 0.5%. Only seven HCWs fulfilled the criteria for treatment and five of them were treated. CONCLUSION Few HCWs in Mauritania are immunised against HBV. The prevalences of anti-HBc Ab and HBsAg observed in this work were similar to those observed in our earlier works, whereas prevalence of active HDV infection was less high. HBV and HDV infections are a serious health concern in Mauritania. New recommendations developed in accordance with WHO guidelines should include mandatory HBV screening and immunisation for HCWs.
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Ajayi BB, Latbone S, Igwegbe IU, Kida IM, Goni BW, Samuel OO, Dawurung JS, Ibrahim HM, Danue BA, Abdullahi IN, Oderinde BS. Serological detection of hepatitis B and D virus co-infection among patients attending a tertiary health facility at Maiduguri, Nigeria. THE EGYPTIAN JOURNAL OF INTERNAL MEDICINE 2021. [DOI: 10.1186/s43162-021-00036-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Hepatitis D virus (HDV) is highly pathogenic, and clinical studies revealed that HDV infection aggravates the natural history of the underlying hepatitis B virus (HBV) infection by progression to cirrhosis that leads to early decompensation of liver function compared with HBV mono-infection. To determine the seroprevalence of HDV among HBsAg-seropositive patients and associated biochemical profiles at Maiduguri, Nigeria, a hospital-based cross-sectional study on 180 sera of patients positive for HBsAg by ELISA were evaluated for anti-HDV, hepatitis B envelop antigen, anti-HBs antibodies and liver enzyme profiles.
Results
HDV seroprevalence of 3.3% among 180 HBsAg-positive patients. Relatively higher seroprevalence of HDV was observed in males (4.3%) than in females (2.3%). The highest infection rate (20%) was obtained in patients ≥ 56 years. However, no significant association between positive anti-HDV seroprevalence and gender (p > 0.05). Of the 6 (3.3%) anti-HDV-positive patients, only 1 (16.7%) was positive for HBeAg while all were negative for anti-HBs antibodies. The mean level of liver enzyme level of AST and ALT of the anti-HDV-positive patients significantly differ from that of HBsAg mono-infected patients (p ˂ 0.05). However, no significant difference (p < 0.05) between the mean levels of liver enzymes of ALP in anti-HDV-positive and HBsAg mono-infected patients (p ˃ 0.05) was found.
Conclusion
This study revealed a relatively low presence of HDV in HBsAg-positive patients. Furthermore, HDV-HBV co-infected patients had somewhat worse liver enzyme upregulation. This underscores the need for rapid HDV testing and treatment in HBV-infected patients.
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