Hepatit B ile enfekte bireylerde delta hepatit seroprevalansı ve klinik özellikler: tek merkezli retrospektif bir çalışma

Year 2025, Volume: 16 Issue: 3, 439 - 443, 30.09.2025

Berfin Çirkin Doruk , Mustafa Uğuz , Sibel Kuyugöz Gülbudak , Fatih Erdem

https://doi.org/10.18663/tjcl.1616759

https://izlik.org/JA69ZT77BY

Abstract

Amaç: Bu çalışmanın amacı, hepatit B yüzey antijeni (HBsAg) pozitif bireylerde delta hepatit (HDV) seroprevalansını ve HDV RNA pozitifliğinin klinik etkilerini değerlendirmektir.
Gereç ve Yöntemler: Ocak 2020 ile Aralık 2022 tarihleri arasında bir üçüncü basamak merkezde takip edilen HBsAg pozitif 89 hastanın tıbbi kayıtları retrospektif olarak incelendi. Anti-HDV ve HDV RNA sonuçlarına göre hastalar gruplandırıldı. Klinik, biyokimyasal ve virolojik parametreler karşılaştırıldı. Siroz ve hepatoselüler karsinom (HCC) gibi komplikasyonlar ayrıca değerlendirildi.
Bulgular: Olguların yaş ortalaması 51,7 ± 13,3 yıl olup, %56,2’si erkekti. Anti-HDV pozitiflik oranı %98,9, HDV RNA pozitiflik oranı %32,6 olarak bulundu. HDV RNA pozitif grupta albümin ve trombosit düzeyleri anlamlı olarak daha düşük; INR anlamlı olarak daha yüksekti. Siroz oranı HDV RNA pozitif bireylerde %50 iken, negatif grupta %16,3’tü. HDV RNA pozitif grubun tamamı antiviral tedavi almıştı.
Sonuç: Çalışmamız, delta hepatit enfeksiyonunun seroprevalansının yüksek olduğu bölgelerde düzenli taramanın önemini vurgulamaktadır. HDV RNA pozitifliği, karaciğer fonksiyonlarında bozulma ve siroz gelişimi ile yakından ilişkilidir. Tedaviye erişim ve izlem süreçleri bu hasta grubu için hayati önemdedir.

Keywords

Delta hepatit , HDV RNA , seroprevalans , siroz , kronik hepatit B

Ethical Statement

Çalışma, Karabük Üniversitesi Girişimsel Olmayan Klinik Araştırmalar Etik Kurulu tarafından onaylanmıştır (Karar No: 2023/1377).

Seroprevalence and clinical ımpact of hepatitis D virus ınfection in ındividuals with chronic hepatitis B: a single-center retrospective analysis

https://izlik.org/JA69ZT77BY

Abstract

Aim: This study aimed to evaluate the seroprevalence of hepatitis D virus (HDV) and the clinical impact of HDV RNA positivity among individuals who tested positive for hepatitis B surface antigen (HBsAg).
Material and Methods: Medical records of 978 HBsAg-positive patients followed between January 2020 and December 2022 in a tertiary care center were retrospectively reviewed. Patients were grouped according to anti-HDV and HDV RNA results. Clinical, biochemical, and virological parameters were compared. Complications such as cirrhosis and hepatocellular carcinoma (HCC) were also evaluated.
Results: Among the 978 HBsAg-positive patients, 89 (9.1%) were found to be delta antigen positive. The mean age of these 89 patients was 51.7 ± 13.3 years, and 56.2% were male. Anti-HDV positivity was detected in 98.9% (n=88) of the patients, and HDV RNA positivity was found in 32.6% (n=29). The mean ALT level was significantly lower in the HDV RNA-positive group (21.5 ± 3.5 vs. 38.4 ± 30.5 U/L; p = 0.0043). Differences in AST, albumin, INR, platelet count, and AFP levels were not statistically significant. The rate of cirrhosis was 50% in the HDV RNA-positive group and 16.3% in the negative group. All HDV RNA-positive patients had received antiviral therapy.
Conclusion: Our findings highlight the importance of routine screening for HDV in regions with high prevalence. HDV RNA positivity is closely associated with impaired liver function and cirrhosis development. Improving treatment access and follow-up strategies is essential for the optimal management of this patient group.

Keywords

Hepatitis D , HDV RNA , seroprevalence , cirrhosis , chronic hepatitis B

Ethical Statement

The study was approved by the Karabük University Non-Interventional Clinical Research Ethics Committee (Decision No: 2023/1377).

References

• Niro GA, Ferro A, Cicerchia F, Brascugli I, Durazzo M. Hepatitis delta virus: From infection to new therapeutic strategies. World J Gastroentero. 2021; 27: 3530-42.
• Yurdaydin C. New treatment options for delta virus: Is a cure in sight? J Viral Hepat 2019; 26: 618-26.
• Stockdale AJ, Kreuels B, Henrion MYR et al. The global prevalence of hepatitis D virus infection: systematic review and meta-analysis. J Hepatol 2020; 73: 523-32.
• Miao Z, Zhang S, Ou X, et al. Estimating the global prevalence, disease progression, and clinical outcome of hepatitis delta virus infection. J Infect Di. 2020; 221: 1677-87.
• Chen HY, Shen DT, Ji DZ, et al. Hepatitis D virus infection: A global update and future directions. World J Gastroenterol 2023; 29: 2217-32.
• Zhang Z, Urban S. Interplay between hepatitis D virus and host immunity: From pathogenesis to therapy. J Hepato. 2023; 79: 916-28.
• Wedemeyer H, Schöneweis K, Bogomolov P, et al. Safety and efficacy of bulevirtide in patients with chronic hepatitis delta. N Engl J Med 2021; 384: 1586-97.
• EASL. Clinical Practice Guidelines on hepatitis B and D. J Hepatol 2023; 79: S469–S510.
• Abbas Z, Abbas M, Abbas S, Shazi L. Management of hepatitis D: A review of current strategies and future options. World J Gastroenterol 2022; 28: 454-67.
• Heidrich B, Serrano BC, Idilman R, et al. Virological response and clinical outcomes in patients with chronic hepatitis delta. J Hepato. 2020; 73: 532-9.
• Tozun N, Ozdogan O, Cakaloglu Y, et al. Seroprevalence of hepatitis B and C virus infections and risk factors in Turkey: a fieldwork TURHEP study. Clin Microbiol Infec. 2015; 21: 1020-6.
• Sahin A, Gurocak S, Tunc N, et al. Anti-HDV seroprevalence among patients with previous HBV infection. North Clin Istanb. 2018; 5: 132-8.
• Flisiak R, Horban A, Pawłowska M, et al. Predictors of low ALT activity in patients with hepatitis B-related cirrhosis. J Viral Hepa. 2021; 28: 800-7.
• Loglio A, Ferenci P, Uceda Renteria SC, et al. Bulevirtide for chronic hepatitis D: a real-world multicenter cohort study. Gut 2022; 71: 1388-96.
• van Bömmel F, Idilman R, Wedemeyer H. Current and future treatment strategies for hepatitis D. Liver Int 2022; 42: 30-9.
• Coghill S, McNamara J, Woods M, Hajkowicz K. Epidemiology and clinical outcomes of hepatitis delta (D) virus infection in Queensland, Australia. Int J Infect Dis 2018; 74: 123-7.
• Ozkan H, Baser B, Artuk C, et al. Seroprevalence and clinical features of hepatitis delta virus infection in chronic hepatitis B patients: A multicenter study from Turkey. Turk J Gastroenterol 2023; 34: 265-72.
• Abbas Z, Jafri W, Raza S. Hepatitis D: scenario in the Asia-Pacific region. World J Gastroenterol 2023; 29: 1234-42.