Hepatitis E Virus Seroprevalence in Patients with Hepatitis Delta Virus Infection

Year 2020, Volume: 5 Issue: 1, 1 - 7, 31.03.2020

Aysun Özel Yeşilyurt Arzu Ayraler Selim Turfan , Ahmet Cumhur Dülger Muhammed Ali Ayvaz

https://doi.org/10.26453/otjhs.475340

Cited By: 1

Abstract

Objective: The current
study was conducted in order to reveal the epidemiologic, biochemical and
virologic properties of the HEV cases particularly in patients with HDV
infection. We also analysed the impact of HDV infection on HEV seroprevalence
in Van region of eastern part of Turkey where the both diseases are still
endemic.

Material and
Methods: 198 individuals
that admitted to a tertiary hospital in the period of between May 2015 and May
2018 were retrospectively examined. Epidemiologic data, results of the
biochemical, serologic and virologic tests were recorded.

Results:Our analysis
proved higher seroprevalence both of Anti HEV Ig G and anti HEV Ig M in most
patients hospitalised with chronic HDV infection than in patients with chronic
HBV infection (77% versus 44%; p=0.001 and 23% versus 6%; p=0.003,
respectively). We also noticed that there were higher levels of AST (49±34
versus 26±12 U/L; p=0.005) and ALT (45±27 versus 28±15 U/L; p=0.001) and lower
levels of platelet (159.000±91.000 versus 223.000±69.000 /mm³; p<0.001)
and serum albumin (3.8±0.8 versus 4.2±0.3 mg/dl.; p<0.001) in chronic HDV
patients than in chronic hepatitis B patients.

Conclusion: Presence of
HDV infection is a major risk factor for spreading HEV infection because of
same environmental conditions. We conclude that patients with HDV infection
have a considerable role in the transmission of the disease due to impaired
liver condition. Additionally, delta hepatitis remains a serious health concern
particularly in patients older than 45 years. Larger case series are needed to
accurately guide in the success of the disease treatment. 

Keywords

Hepatitis B virus, Hepatitis D virus, Hepatitis Delta virus, Hepatitis E virus, Seroprevalence

Hepatit Delta Virüs ile Enfekte Hastalarda Hepatit E Seroprevalansı

Abstract

Amaç: Bu çalışmanın amacı özellikle HDV ile enfekte hastalarda HEV
enfeksiyonunun epidemiyolojik, biyokimyasal ve virolojik özelliklerini açığa çıkarmaktır.
Ayrıca HDV enfeksiyonunun HEV seroprevalansı üzerine etkisini, her iki
hastalığında endemik olduğu Van ilinde araştırdık.

Materyal ve Metod:2015 Mayıs ve
2018 Mayıs ayları arasında 3.basamak hastanemize başvuran 198 vakaretrospektif
olarak incelendi. Epidemiyolojik veriler, biyokimyasal, serolojik ve virolojik
testlerin sonuçları kaydedildi.

Bulgular: Araştırmamızda kronik HDV enfeksiyonlu hastalarda kronik HBV
enfeksiyonlulara göre hem anti-HEV IgG hem de anti-HEV IgM düzeyleri daha yüksekti(sırasıyla
%77’ye karşı %44, p=0,001 ve %23’e karşı %6, p=0,003). Ayrıca Kronik HDV
enfeksiyonlu hastalarda kronik HBV enfeksiyonlulara göre daha yüksek AST (49±34’e karşı 26±12 U/L, p=0,005) ve ALT
(45±27’ye karşı 28±15, p=0,001) seviyeleri ile daha düşük trombosit
(159000±91000’e karşı 223000±69000/mm³, p<0,001) ve serum albumin
(3,8±0,8’e karşı 4,2±0,3 mg/dl, p<0,001) seviyeleri gözlemlendi.

Sonuç: Aynı çevresel koşullardan ötürü HDV
enfeksiyonunun bulunuşu HEV enfeksiyonu yayılımı için major bir risk faktörüdür.
Biz bozulmuş karaciğer durumuna bağlı olarak hastalığın yayılımında HDV
enfeksiyonlu hastaların hatrı sayılır bir rolü olduğu sonucunu çıkarıyoruz. Ek
olarak delta hepatiti özellikle 45 yaş üstü hastalarda önemli bir halk sağlığı
problemi olarak devam etmektedir. Hastalığın tedavi başarısına yön vermesi için
daha geniş ölçekli çalışmalara ihtiyaç vardır.

Keywords

Hepatit B virüs, Hepatit D virüs, Hepatit Delta virüs, Hepatit E virüs, Seroprevalans

References

• 1. Noureddin M, Gish R. Hepatitis Delta: Epidemiology, Diagnosis and Management 36 Years After Discovery.CurrGastroenterol Rep. 2014;16:365.
• 2. Safaie P, Razeghi S, Rouster SD, Privitera I, Sherman KE. Hepatitis D diagnostics: Utilization and testing in the United States. Virus Res. 2018;250:114-117.
• 3. Dulger AC, Suvak B, Gonullu H et al. High prevalence of chronic hepatitis D virus infection in Eastern Turkey: urbanization of the disease. Arch Med Sci. 2016;12(2):415-20.
• 4. Bai MJ, Zhou N, Dong W, Li GX, Cong W, Zhu XQ. Seroprevalence and risk factors of hepatitis E virus infection in cancer patients in eastern China.Int J Infect Dis. 2018;71:42-47.
• 5. Hofmeister MG, Foster MA, Teshale EH. Epidemiology and Transmission of Hepatitis A Virus and Hepatitis E Virus Infections in the United States.Cold Spring HarbPerspect Med. 2018.Doi: 10.1101/cshperspect.a033431.
• 6. Dalton HR, Izopet J. Transmission and Epidemiology of Hepatitis E Virus Genotype 3 and 4 Infections. Cold Spring HarbPerspect Med. 2018.Doi: 10.1101/cshperspect.a032144.
• 7. Leblebicioglu H, Ozaras R. Hepatitis E virus infection in Turkey: a systematic review. Ann ClinMicrobiolAntimicrob. 2018;17(1):17.
• 8. Nan Y, Wu C, Zhao Q, Zhou EM. Zoonotic Hepatitis E Virus: An Ignored Risk for Public Health. Front Microbiol. 2017;8:2396.
• 9. Pérez-Gracia MT, Suay-García B, Mateos-Lindemann ML. Hepatitis E and pregnancy: current state Rev Med Virol. 2017. Doi: 10.1002/rmv.1929. [Epub ahead of print].
• 10. Faber M, Willrich N, Schemmerer M et al.Hepatitis E virus seroprevalence, seroincidence and seroreversion in the German adult population. J Viral Hepat. 2018. Doi:10.1111/jvh.12868. [Epub ahead of print].
• 11. Zhang L, Jiang Z, Lv J et al. Comparison of hepatitis E virus seroprevalence between HBsAg-positive population and healthy controls in Shandong province, China. BMC Infectious Diseases. 2018;18:75.
• 12. Wranke A, PinheiroBorzacov LM, Parana R et al. Clinical and virological heterogeneity of hepatitis delta in different regions world-wide: The Hepatitis Delta International Network (HDIN). Liver Int. 2018;38(5):842-850.
• 13. López-Fabal MF, Gómez-Garcés JL. Seroprevalence of hepatitis E virus in patients with hepatitis C and / or infected with HIV. Rev EspQuimioter. 2015;28(6):314-316.
• 14. Halánová M1, Veseliny E2, Kalinová Z et al. Seroprevalence of Hepatitis E Virus in Roma Settlements: A Comparison with the General Population in Slovakia. Int J Environ Res Public Health. 2018;15(5):904.
• 15. Kamar N, Abravanel F, Selves Jet al. Influence of immunosuppressive therapy on the natural history of genotype 3 hepatitis-E virus infection after organ transplantation. Transplantation. 2010;89:353-360.
• 16. Tavitian S, Peron JM, Huguet F et al. Ribavirin for chronic hepatitis prevention among patients with hematologic malignancies. Emerg Infect Dis. 2015;21:1466-1469.