HBV and HDV Seroprevalence among Healthy People Admitted for Hepatitis B Vaccination

Yıl 2019, Cilt: 13 Sayı: 1, 60 - 66, 11.03.2019

Attiya Sabeen Rahman Muhammad Amir Muhammad Asadullah Siddiqui , Qaiser Jamal Mehwish Riaz Adnan Aziz

https://doi.org/10.21763/tjfmpc.528253

Cited By: 1

Öz

Background: An estimated 350 million persons worldwide are
chronically infected with Hepatitis B virus (HBV). These are at increased risk
of developing liver cirrhosis and hepatocellular carcinoma. The aim of the
study was to determine the prevalence of Hepatitis B and co- existing Hepatitis
D and to investigate the pattern of lab parameters among patients positive for
hepatitis B and/or D. Methods: This
is an observational cross-sectional prospective study conducted from 2009 to
2014 in Lyari General Hospital Karachi Pakistan. A total of 10270 patients were
registered in the liver clinic from June 2009 to December 2014 for hepatitis B
vaccination. All patients who had visited the Liver clinic of Lyari General
Hospital for hepatitis B vaccination were first screened for hepatitis B, and D
viruses by HBsAg, and Anti HDV antibodies and anti HCV by ELISA method.
Patients who had HBsAg negative were then vaccinated. If HBsAg was found to be positive
the patients have been underwent through further tests for the confirmation of
hepatitis B and D (Hepatitis B Virus DNA polymerase chain reaction (PCR),
hepatitis B e-antigen (HBeAg), hepatitis Be antibody (HBeAb), and if anti HDV
positive then HDV RNA PCR was performed). Patients found to have a positive
HBVDNA PCR with positive or negative HBeAg were treated. Patients with positive
HBeAb were seroconverted. Patients with a positive anti HDV antibody underwent
an HDVRNA PCR and if positive were treated. Statistical analysis was performed
using SPSS (IBM SPSS Statistics 24.0).
Results: A total of 10270 patients were registered in the liver clinic.
Overall 206 (2%) were found to be HBV positive, in which 26.2% had Hepatitis D
co-infection. More than half (57.3%) were male and 70.4% were married with the
mean age of 33.2 ± 10.9 years. About one-fourth of the total were HbeAg
positive (25.2%) and hepatitis D antibody positive (26.2%), while 21% had HDV
PCR positive and 6.3% had hepatitis C antibody positive. The mean hemoglobin
was 12.2, white cell count 6052.3, viral load of HBV DNA was 44100856.97, SGPT
was 63.47, albumin was 4.24 and mean INR was 1.09. Conclusion: Prevalence of Hepatitis B infection was 2% and
Hepatitis D infection was present in 26.2% of hepatitis B infected patients.

 

Giriş: Dünya genelinde 350 milyon kişinin Hepatit B
virüsü (HBV) ile kronik olarak enfekte olduğu tahmin edilmektedir. Bu kişier
karaciğer sirozo ve hepatoselüler karsinom gelişimi riski altındadır. Bu
çalışmanın amacı Hepatit B ve ko-enfeksiyon olarak Hepatit D virusunun
prevelansını saptamak ve Hepatit B ve/ya Hepatit D pozitif hastalar arasında
laboratuvar parametrelerinin örüntülerini inceleyebilmektir. Yöntem: Bu gözlemsel
tanımlayıcı-kesitsel prospektif çalışma, 2009-2014 yılları arasında Lyari Genel
Hastanesi, Karaçi, Pakistan’da yapıldı. Haziran 2009’dan Aralık 2014’e kadar toplam
10270 hasta karaciğer polikliniği’ne hepatit B aşılaması için kaydolmuştur.
Lyari Genel Hastanesi’nde Karaciğer kliniğine hepatit B aşılaması için başvuran
hastaların hepsi ilk gelişlerinde ELISA yöntemiyle hepatit B ve D virusleri
için HBsAg, Anti HDV antikorları ve anti HCV için tarandılar. HBsAg negatif
olan hastalar aşılandı. Eğer HBsAg pozitif bulgulandıysa hastalara hepatit B ve
D doğrulaması için ileri testler yapıldı ( Hepatit B virus DNA polimeraz zincir
reaksiyonu (PCR), hepatit B e-antijeni (HbeAb) ve eğer anti HDV pozitif ise HDV
RNA PCR uygulandı). Pozitif HBVDNA PCR sonucu ile pozitif ya da negatif HbeAg
sonucu olan hastalar tedavi edildi. İstatiksel yöntem olarak SPSS kullanıldı
(IBM SPSS Statistics 24.0). Bulgular:
Karaciğr kliniğine toplamda 10270 hasta kaydoldu. Bunlardan 206’sı (%2) HBV
pozitif olarak bulgulandı ki %26.2’de Hepatit D ko-enfeksiyonu vardı.
Yarısından fazlası (%57.3) erkekti ve %70.4’ü evliydi, yaş ortlaması ise 33.2 ± 10.9 yıldı. Bütünün dörte birinde HBsAg
pozitif (%25.2) ve hepatit D antikoru pozitif (%26.2) iken %21 HDV pozitif ve
%6.3 hepatit C antikoru pozitifti. Ortalama hemoglobin değeri 12.2, beyaz küre
sayısı 6052.3, HBV DNA’nın viral yükü 44100856.97, SGPT 63.47, albumin 4.24 ve
ortalama INR 1.09 idi. Sonuç:
Hepatit B enfeksiyonu prevelansı %2’dir ve Hepatit D ise hepatit B ile enfekte
hastaların %26.2’sinde bulunmaktadır.

Anahtar Kelimeler

Chronic hepatitis B, chronic hepatitis C, cirrhosis, co-infection, hepatitis delta virus, epidemiology

Kaynakça

• 1. World Health Organisation. Hepatitis D. [Online]. Available at < http://www.who.int/news-room/fact-sheets/detail/hepatitis-d > Last Accessed Aug 13, 2018.
• 2. Hwang EW, Cheung R. Global Epidemiology of hepatitis B virus infection. N A J Med Sci. 2011 4:7-13.
• 3. Wasley A, Kruszon-Moran D, Kuhnert W, et al. The prevalence of hepatitis B virus infection in the United States in the era of vaccination. J. Infect. Dis. 2010;202:192-201.
• 4. Zhang J, Zou S, Guilivi A. Epidemiology of hepatitis B in Canada. Can. J. Infect. Dis. 2001;12:345-450.
• 5. Muir AJ. Understanding the Complexities of Cirrhosis. Clin. Ther. 2015;37:1822-36.
• 6. Department of health & human services. Centers for Disease Control and Prevention [Online]. Availaible at < https://www.cdc.gov/hepatitis/hbv/pdfs/SerologicChartv8.pdf> Last Accessed Aug 13, 2018.
• 7. Custer B, Sullivan SD, Hazlet TK, Iloeje U, Veenstra DL, Kowdley KV. Global epidemiology of hepatitis B virus. J. Clin. Gastroenterol. 2004;38:S158-68.
• 8. Rantala M, van de Laar MJ. Surveillance and epidemiology of hepatitis B and C in Europe - a review. Euro Surveill. 2008;13.
• 9. Goudeau A. European Regional Study Group. Epidemiology and eradication strategy for hepatitis B in Europe. Vaccine. 1990;8:S113-S6.
• 10. Magdzik WW. Hepatitis B epidemiology in Poland, Central and Eastern Europe and the newly independent states. Vaccine. 2000;18 Suppl 1:S13-6.
• 11. Shalaby S, Kabbash IA, El Saleet G, Mansour N, Omar A, El Nawawy A. Hepatitis B and C viral infection: prevalence, knowledge, attitude and practice among barbers and clients in Gharbia governorate, Egypt. Eastern Mediterranean health journal = La revue de sante de la Mediterranee orientale = al-Majallah al-sihhiyah li-sharq al-mutawassit. 2010;16:10-7.
• 12. Sherif MM, Abou-Aita BA, Abou-Elew MG, El-Kafrawi AO. Hepatitis B virus infection in upper and lower Egypt. J. Med. Virol. 1985;15:129-35.
• 13. Kiire CF. Hepatitis B infection in sub-Saharan Africa. The African Regional Study Group. Vaccine. 1990;8 Suppl:S107-12; discussion S34-8.
• 14. Kiire CF. The epidemiology and prophylaxis of hepatitis B in sub-Saharan Africa: a view from tropical and subtropical Africa. Gut. 1996;38 Suppl 2:S5-12.
• 15. John TJ, Abraham P. Hepatitis B in India: a review of disease epidemiology. Indian Pediatr. 2001;38:1318-25.
• 16. Khattak MF, Salamat N, Bhatti FA, Qureshi TZ. Seroprevalence of hepatitis B, C and HIV in blood donors in northern Pakistan. J. Pak. Med. Assoc. 2002;52:398-402.
• 17. Sami S, Korejo R, Bhutta SZ. Prevalence of hepatitis B and hepatitis C: a Jinnah Postgraduate Medical Center experience. J. Obstet. Gynaecol. Res. 2009;35:533-8.
• 18. Gish RG, Yi DH, Kane S, et al. Coinfection with hepatitis B and D: epidemiology, prevalence and disease in patients in Northern California. J. Gastroenterol. Hepatol. 2013;28:1521-5.
• 19. Bosan A, Qureshi H, Bile KM, Ahmad I, Hafiz R. A review of hepatitis viral infections in Pakistan. J. Pak. Med. Assoc. 2010;60:1045-58.
• 20. Zuberi SJ. An overview of HBV/HCV in Pakistan. . Pak. J. Med. Res. 1998;37:12.
• 21. Mumtaz K, Hamid SS, Adil S, et al. Epidemiology and clinical pattern of hepatitis delta virus infection in Pakistan. J. Gastroenterol. Hepatol. 2005;20:1503-7.