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HDV infection rates in northern Vietnam
Mai Thanh Binh1,2,3, Nghiem Xuan Hoan1,2,3, Hoang Van Tong1,2,4
1Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany.
Insights
Hepatitis D virus (HDV) infection is common in Vietnamese hepatitis B patients, particularly those with liver cirrhosis or cancer. HDV genotype 1 is predominant, highlighting the need for HDV testing.
Area of Science:
- Hepatology
- Virology
- Infectious Diseases
Background:
- Hepatitis D virus (HDV) infection poses a significant global health challenge, particularly in regions with high hepatitis B virus (HBV) prevalence.
- HDV/HBV coinfection is associated with more severe liver disease progression compared to HBV monoinfection.
Purpose of the Study:
- To determine the prevalence and genotypes of HDV among HBV-infected patients in northern Vietnam.
- To investigate the association between HDV coinfection and clinical outcomes in patients with chronic hepatitis B (CHB), liver cirrhosis (LC), and hepatocellular carcinoma (HCC).
Main Methods:
- A cohort of 546 HBV-infected patients (2013-2015) was screened for HDV-RNA using nested PCR assays.
- HDV genotypes were identified through direct sequencing and phylogenetic analysis.
- Clinical data including CHB, LC, and HCC status were collected and analyzed.
Main Results:
- HDV-RNA was detected in 13% (71/546) of HBV-infected patients.
- HDV prevalence was highest in the liver cirrhosis group (19.7%), followed by hepatocellular carcinoma (12%) and chronic hepatitis B (8.9%).
- HDV genotype 1 was the predominant genotype (91%), with HDV genotype 2 observed in 9% of cases.
Conclusions:
- A high prevalence of HDV infection persists among HBV patients in northern Vietnam, with HDV genotype 1 remaining dominant.
- HDV/HBV coinfection is linked to unfavorable clinical outcomes, especially liver cirrhosis development.
- Routine HDV nucleic acid testing is recommended to mitigate associated risks.
Abstract:
Hepatitis D caused by the hepatitis delta virus (HDV) is a serious health problem in many regions of the world. A total of 546 HBV-infected patients were enrolled from 2013 to 2015 and classified clinically into the subgroups of chronic hepatitis B (CHB, n = 191), liver cirrhosis (LC, n = 147) and hepatocellular carcinoma (HCC, n = 208). The patients were screened for HDV-RNA by nested PCR assays. HDV genotypes were assessed by direct sequencing, followed by phylogenetic analysis. HDV-RNA was identified in 13% (71/546) of HBV-infected patients. The highest HDV prevalence was found in the LC group (19.7%), followed by the HCC (12%) and CHB (8.9%) groups (P = 0.017). HDV/HBV coinfections were significantly associated with a rather unfavourable clinical outcome, in particular with LC development compared to HBV monoinfection. Phylogenetic analyses indicated that the genotype HDV1 was, with a prevalence of 91%, by far the most common genotype in Vietnam, followed by HDV2 with 9%. Other HDV genotypes were not observed. In accordance with previous data obtained a decade ago, our results confirm a continuing high prevalence of HDV infection in hepatitis B patients in northern Vietnam with the HDV1 genotype still being the predominant genotype. HDV nucleic acid testing to minimize the associated risk should be considered.
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