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Abstract:
It is estimated that approximately 70 to 80% of the world's HBsAg carriers live in Southeast Asia, but studies of delta infection in this area are still limited. We studied 323 HBsAg seropositive patients in Japan, and 4 (1.2%) of them were found to be positive for anti-delta antibody, with none positive for delta antigen. These four patients did not belong to the known high-risk groups for delta infection. One HBeAg positive female gave birth to a baby girl, and perinatal transmission of hepatitis B virus and delta was successfully blocked by a combination of hepatitis B immunoglobulin and vaccine. This study in the Tokyo-Chiba area showed delta infection, though low in frequency, among ordinary Japanese citizens. It has been reported that delta antigen is highly infectious to HBsAg carriers and that its infection will cause severe liver damage. Once introduced, it could become epidemic among non-drug users in a country where hepatitis B virus infection is endemic. At this moment, the only way of preventing such a disaster appears to be to reduce the number of chronic carriers by interruption of vertical transmission.
Insights
Hepatitis delta virus (HDV) infection is low in Japan, with 1.2% of HBsAg carriers testing positive for anti-delta antibodies. Perinatal transmission was blocked, highlighting the need to reduce chronic hepatitis B carriers.
Area of Science:
- Hepatology
- Virology
- Infectious Diseases
Background:
- Hepatitis B virus (HBV) infection is endemic in Southeast Asia, with a high prevalence of surface antigen (HBsAg) carriers.
- Delta infection studies in this region are limited, despite HDV's potential to cause severe liver damage in HBsAg carriers.
- Understanding HDV prevalence in non-high-risk populations is crucial for public health strategies.
Purpose of the Study:
- To investigate the prevalence of delta infection among HBsAg-positive patients in Japan.
- To assess the risk of perinatal transmission of HBV and HDV.
- To evaluate preventive measures against delta infection.
Main Methods:
- Serological testing for HBsAg, anti-delta antibody, and delta antigen in 323 HBsAg-positive patients.
- Identification of high-risk groups for delta infection.
- Monitoring of perinatal transmission in an HBeAg-positive mother and infant.
Main Results:
- Four out of 323 (1.2%) HBsAg-positive patients tested positive for anti-delta antibody; none were positive for delta antigen.
- The identified positive cases did not belong to known high-risk groups for delta infection.
- Perinatal transmission of HBV and HDV was successfully prevented in one case using hepatitis B immunoglobulin and vaccine.
Conclusions:
- Delta infection is present, though infrequent, among ordinary Japanese citizens.
- The study highlights the potential for delta infection to spread among HBsAg carriers.
- Interrupting vertical transmission of HBV is a key strategy to reduce the chronic carrier pool and prevent potential delta infection epidemics.