A study of HDV in HBsAg positive patients in Tabriz, Northwestern Iran

Hepatitis Delta Virus (HDV) is a defective ssRNA virus requiring the provision of hepatitis B virus (HBV) for packaging of new HDV virions. Since the epidemiological features of HDV in this part of Iran seem to be unknown, the aim of this research was to determine the seroprevalence of HDV of hepatitis B surface antigen positive (HBsAg+) in blood donors, injecting drug users, hemophiliacs, hemodialysis and thalassemic patients in the city of Tabriz in northwestern Iran.

The numbers of patients who were screened in the years 2006-2007 were 100 hemodialysis patients, 165 blood donors and 90 intravenous drug users, or a total of 355 patients who were HBsAg+ and randomly selected at the Tabriz Regional Educational Blood Center. Anti-HDV antibodies (IgM), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels in serum samples were measured.

Eight of the hemodialysis patients (8%), 3 of the 165 blood donors (1.8%) and 9 intravenous drug addicts (10%) were HDV-IgM antibody-positive. Out of 152 serum samples collected in the hemophiliac population, only 11 samples were HBsAg+ (7.23%), and anti-HDV IgM antibodies were detected in just 2 cases. Also out of 112 thalassemic patients' sera specimens, only 2 samples was HBsAg+, and HDV-IgM antibodies were negative. The seropositivity of anti- HDV antibodies was 6.01%. The study of serum ALT levels in HBV-positive and HDV-positive patients showed obvious elevation in more than 95% of cases.

The results show the endemicity of HDV infection in Tabriz. HDV infection in Iran could be controlled by nationwide HBV vaccination.