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Grecu LI, Pavel-Tanasa M, Matei L, Sultana C, Ruta SM, Grecu RI, Ursu RG, Cianga P, Iancu LS. Molecular Epidemiology of Hepatitis D Virus in the North-East Region of Romania. Pathogens 2024; 13:793. [PMID: 39338984 PMCID: PMC11435033 DOI: 10.3390/pathogens13090793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2024] [Revised: 09/07/2024] [Accepted: 09/10/2024] [Indexed: 09/30/2024] Open
Abstract
The hepatitis D virus (HDV) superinfection of individuals with chronic hepatitis B virus (HBV) infection causes severe liver damage and the poorest long-term prognosis among viral hepatitis. This is attributed to the unique pathogenic mechanisms of HDV characterized by a direct cytopathic effect on hepatocytes and a significant impairment of the host immune response. The HDV genotype largely influences the extent of the pathogenic mechanisms with consequences on disease progression towards cirrhosis, liver decompensation, or hepatocellular carcinoma. In this context, identifying the circulating HDV genotypes in European regions with high prevalence, such as Romania, is crucial for effectively managing the long-term liver health. Here, we report the first comprehensive HDV study in Romania that clinically characterizes 82 patients and performs HDV genotyping by combining the nested-PCR reaction with sequencing analysis in 49 samples with an HDV-RNA load higher than 5000 IU/mL. While all isolates in our study belong to the HDV-1 genotype, the phylogenetic analysis based on sequence data from GenBank reveals the presence of the following potential three groups: (i) Italy and France; (ii) Spain; and (iii) Turkey, Iran, Pakistan, and Germany. This broad clustering highlights the recent surge in migration to and from Western Europe and the Middle East. Equally important, no differences in viral markers, clinical and paraclinical parameters, or treatment options were observed between these identified clusters. Nevertheless, this study considerably advances the understanding of hepatitis D epidemiology and clinical aspects in Romania.
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Affiliation(s)
- Laura Iulia Grecu
- Department of Preventive Medicine and Interdisciplinarity Microbiology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (L.I.G.); (R.I.G.); (R.G.U.); (L.S.I.)
- Department of Emerging Viral Diseases, “Stefan S. Nicolau” Institute of Virology, 030304 Bucharest, Romania; (C.S.); (S.M.R.)
| | - Mariana Pavel-Tanasa
- Department of Immunology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania;
- Laboratory of Immunology, St. Spiridon County Clinical Emergency Hospital, 700111 Iasi, Romania
| | - Lilia Matei
- Department of Cellular and Molecular Pathology, “Stefan S. Nicolau” Institute of Virology, 030304 Bucharest, Romania
| | - Camelia Sultana
- Department of Emerging Viral Diseases, “Stefan S. Nicolau” Institute of Virology, 030304 Bucharest, Romania; (C.S.); (S.M.R.)
| | - Simona Maria Ruta
- Department of Emerging Viral Diseases, “Stefan S. Nicolau” Institute of Virology, 030304 Bucharest, Romania; (C.S.); (S.M.R.)
| | - Razvan Ioan Grecu
- Department of Preventive Medicine and Interdisciplinarity Microbiology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (L.I.G.); (R.I.G.); (R.G.U.); (L.S.I.)
- Diaverum Romania, 011857 Bucharest, Romania
| | - Ramona Gabriela Ursu
- Department of Preventive Medicine and Interdisciplinarity Microbiology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (L.I.G.); (R.I.G.); (R.G.U.); (L.S.I.)
- Microbiology Department, Gynecology and Obstetrics Hospital-Cuza Voda, 700038 Iasi, Romania
| | - Petru Cianga
- Department of Immunology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania;
- Laboratory of Immunology, St. Spiridon County Clinical Emergency Hospital, 700111 Iasi, Romania
| | - Luminita Smaranda Iancu
- Department of Preventive Medicine and Interdisciplinarity Microbiology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (L.I.G.); (R.I.G.); (R.G.U.); (L.S.I.)
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Akuffo GA, Ouoba S, Ko K, Chhoung C, Phyo Z, Mirzaev UK, Sugiyama A, Akita T, Tanaka J. Assessing the diagnostic accuracy of serological tests for hepatitis delta virus diagnosis: a systematic review and meta-analysis. Sci Rep 2024; 14:18475. [PMID: 39122751 PMCID: PMC11316141 DOI: 10.1038/s41598-024-69304-8] [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: 03/22/2024] [Accepted: 08/02/2024] [Indexed: 08/12/2024] Open
Abstract
Hepatitis Delta Virus (HDV), a satellite virus of Hepatitis B virus, exacerbates liver damage in affected individuals. Screening for HDV antibodies in HBsAg positive patients is recommended, but the diagnostic accuracy of serological tests remains uncertain. This review aimed to assess the diagnostic accuracy of serological tests for HDV. We searched PubMed, Web of Science, Cochrane Central Register of Controlled Trials, Scopus etc. for relevant studies. Studies measuring the sensitivity and specificity of serological HDV tests against PCR as a reference standard were included. Pooled sensitivity and specificity for each test method and sero-marker were calculated. The review included six studies with 11 study arms, evaluating ARCHITECT immunoassay, EIA, ELISA, QMAC, RIA, and Western Blot test methods targeting Anti-HDV IgG, Total anti-HDV and Anti-HDV IgM. Sensitivities for Anti-HDV IgG, Total Anti-HDV and Anti-HDV IgM, tests were 97.4%, 51.9%, and 62.0%, respectively, with specificities of 95.3%, 80.0%, and 85.0%. Our findings, with its limited number of studies, suggest that HDV serological tests, particularly those identifying Anti IgG exhibit high accuracy and can serve as effective screening tools for HDV.
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Affiliation(s)
- Golda Ataa Akuffo
- Department of Epidemiology Infectious Diseases Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami, Hiroshima, 734-8551, Japan
- Project Research Center for Epidemiology and Prevention of Viral Hepatitis and Hepatocellular Carcinoma, Hiroshima University, Hiroshima, Japan
| | - Serge Ouoba
- Department of Epidemiology Infectious Diseases Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami, Hiroshima, 734-8551, Japan
- Project Research Center for Epidemiology and Prevention of Viral Hepatitis and Hepatocellular Carcinoma, Hiroshima University, Hiroshima, Japan
- Unité de Recherche Clinique de Nanoro (URCN), Institut de Recherche en Science de la Santé (IRSS), Nanoro, Burkina Faso
| | - Ko Ko
- Department of Epidemiology Infectious Diseases Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami, Hiroshima, 734-8551, Japan
- Project Research Center for Epidemiology and Prevention of Viral Hepatitis and Hepatocellular Carcinoma, Hiroshima University, Hiroshima, Japan
| | - Chanroth Chhoung
- Department of Epidemiology Infectious Diseases Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami, Hiroshima, 734-8551, Japan
- Project Research Center for Epidemiology and Prevention of Viral Hepatitis and Hepatocellular Carcinoma, Hiroshima University, Hiroshima, Japan
| | - Zayar Phyo
- Department of Epidemiology Infectious Diseases Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami, Hiroshima, 734-8551, Japan
- Project Research Center for Epidemiology and Prevention of Viral Hepatitis and Hepatocellular Carcinoma, Hiroshima University, Hiroshima, Japan
| | - Ulugbek Khudayberdievich Mirzaev
- Department of Epidemiology Infectious Diseases Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami, Hiroshima, 734-8551, Japan
- Project Research Center for Epidemiology and Prevention of Viral Hepatitis and Hepatocellular Carcinoma, Hiroshima University, Hiroshima, Japan
- Department of Hepatology, Scientific Research Instutute of Virology, Ministry of Health, Tashkent, Uzbekistan
| | - Aya Sugiyama
- Department of Epidemiology Infectious Diseases Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami, Hiroshima, 734-8551, Japan
- Project Research Center for Epidemiology and Prevention of Viral Hepatitis and Hepatocellular Carcinoma, Hiroshima University, Hiroshima, Japan
| | - Tomoyuki Akita
- Department of Epidemiology Infectious Diseases Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami, Hiroshima, 734-8551, Japan
- Project Research Center for Epidemiology and Prevention of Viral Hepatitis and Hepatocellular Carcinoma, Hiroshima University, Hiroshima, Japan
| | - Junko Tanaka
- Department of Epidemiology Infectious Diseases Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami, Hiroshima, 734-8551, Japan.
- Project Research Center for Epidemiology and Prevention of Viral Hepatitis and Hepatocellular Carcinoma, Hiroshima University, Hiroshima, Japan.
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Silva RJS, do Nascimento RS, Oliveira-Neto JAJ, Silva FQ, Piauiense JNF, Gomes CM, Pinheiro LML, Resque RL, Pinho JRR, Kupek E, Fischer B, Machado LFA, Martins LC, Lemos JAR, Oliveira-Filho AB. Detection and Genetic Characterization of Hepatitis B and D Viruses: A Multi-Site Cross-Sectional Study of People Who Use Illicit Drugs in the Amazon Region. Viruses 2021; 13:v13071380. [PMID: 34372586 PMCID: PMC8310228 DOI: 10.3390/v13071380] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 07/03/2021] [Accepted: 07/06/2021] [Indexed: 02/06/2023] Open
Abstract
Hepatitis B (HBV) and delta (HDV) viruses are endemic in the Amazon region, but vaccine coverage against HBV is still limited. People who use illicit drugs (PWUDs) represent a high-risk group due to common risk behavior and socioeconomic factors that facilitate the acquisition and transmission of pathogens. The present study assessed the presence of HBV and HBV-HDV co-infection, identified viral sub-genotypes, and verified the occurrence of mutations in coding regions for HBsAg and part of the polymerase in HBV-infected PWUDs in municipalities of the Brazilian states of Amapá and Pará, in the Amazon region. In total, 1074 PWUDs provided blood samples and personal data in 30 municipalities of the Brazilian Amazon. HBV and HDV were detected by enzyme-linked immunosorbent assay and polymerase chain reaction. Viral genotypes were identified by nucleotide sequencing followed by phylogenetic analysis, whereas viral mutations were analyzed by specialized software. High rates of serological (32.2%) and molecular (7.2%) markers for HBV were detected, including cases of occult HBV infection (2.5%). Sub-genotypes A1, A2, D4, and F2a were most frequently found. Escape mutations due to vaccine and antiviral resistance were identified. Among PWUDs with HBV DNA, serological (19.5%) and molecular (11.7%) HDV markers were detected, such as HDV genotypes 1 and 3. These are worrying findings, presenting clear implications for urgent prevention and treatment needs for the carriers of these viruses.
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Affiliation(s)
- Ronylson José S. Silva
- Programa de Pós-Graduação em Biologia Ambiental, Universidade Federal do Pará, Bragança 68600-000, PA, Brazil; (R.J.S.S.); (R.S.d.N.); (C.M.G.)
| | - Raquel Silva do Nascimento
- Programa de Pós-Graduação em Biologia Ambiental, Universidade Federal do Pará, Bragança 68600-000, PA, Brazil; (R.J.S.S.); (R.S.d.N.); (C.M.G.)
| | - José Augusto J. Oliveira-Neto
- Instituto de Estudos Costeiros, Universidade Federal do Pará, Bragança 68600-000, PA, Brazil; (J.A.J.O.-N.); (F.Q.S.)
| | - Fabricio Quaresma Silva
- Instituto de Estudos Costeiros, Universidade Federal do Pará, Bragança 68600-000, PA, Brazil; (J.A.J.O.-N.); (F.Q.S.)
| | - Juliana Nádia F. Piauiense
- Programa de Pós-Graduação em Saúde na Amazônia, Universidade Federal do Pará, Belém 66055-240, PA, Brazil; (J.N.F.P.); (L.C.M.)
| | - Camila Moraes Gomes
- Programa de Pós-Graduação em Biologia Ambiental, Universidade Federal do Pará, Bragança 68600-000, PA, Brazil; (R.J.S.S.); (R.S.d.N.); (C.M.G.)
| | - Luiz Marcelo L. Pinheiro
- Faculdade de Ciências Biológicas, Campus do Marajó, Universidade Federal do Pará, Soure 68870-000, PA, Brazil;
| | - Rafael Lima Resque
- Departamento de Ciências Biológicas e da Saúde, Universidade Federal do Amapá, Macapá 68903-419, AP, Brazil;
| | - João Renato R. Pinho
- Instituto de Medicina Tropical, Universidade de São Paulo, São Paulo 05403-000, SP, Brazil;
| | - Emil Kupek
- Departamento de Saúde Pública, Universidade Federal de Santa Catarina, Florianópolis 88040-900, SC, Brazil;
| | - Benedikt Fischer
- Centre for Applied Research in Mental Health and Addiction, Faculty of Health Sciences, Simon Fraser University, Vancouver, BC V6B 5K3, Canada;
- Faculty of Medical and Health Sciences, University of Auckland, Auckland 1023, New Zealand
- Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo 04038-000, SP, Brazil
| | - Luiz Fernando A. Machado
- Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075-110, PA, Brazil; (L.F.A.M.); (J.A.R.L.)
| | - Luísa Caricio Martins
- Programa de Pós-Graduação em Saúde na Amazônia, Universidade Federal do Pará, Belém 66055-240, PA, Brazil; (J.N.F.P.); (L.C.M.)
- Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém 66055-240, PA, Brazil
| | - José Alexandre R. Lemos
- Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075-110, PA, Brazil; (L.F.A.M.); (J.A.R.L.)
| | - Aldemir B. Oliveira-Filho
- Programa de Pós-Graduação em Biologia Ambiental, Universidade Federal do Pará, Bragança 68600-000, PA, Brazil; (R.J.S.S.); (R.S.d.N.); (C.M.G.)
- Instituto de Estudos Costeiros, Universidade Federal do Pará, Bragança 68600-000, PA, Brazil; (J.A.J.O.-N.); (F.Q.S.)
- Correspondence: ; Tel.: +55-91-3425-1209
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