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Hepatitis D virus antigen in HBsAg positive chronic liver disease in Nigeria
O S Ojo1, A K Akonai, M Thursz
1Department of Morbid Anatomy and Forensic Medicine, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria.
Insights
Hepatitis D virus (HDV) infection is rare in southwestern Nigerians with chronic liver disease. This study found a low prevalence of HDV, suggesting it plays a minor role in HBsAg-associated liver disease in this region.
Area of Science:
- Hepatology
- Virology
- Epidemiology
Background:
- Hepatitis B virus (HBV) is linked to severe liver disease and cancer in sub-Saharan Africa.
- Hepatitis D virus (HDV) coinfection can worsen HBV-related liver conditions.
- The epidemiology of HDV in sub-Saharan Africa is complex and impacts HBV-associated chronic liver disease (CALD).
Purpose of the Study:
- To determine the sero-prevalence of Hepatitis D virus (HDV) in Nigerian patients with HBsAg-positive, HCV antibody-negative chronic liver disease.
- To assess the prevalence of HDV antigen (HDVAg) in healthy Nigerian populations.
- To evaluate the role of HDV in the pathogenesis of HBsAg-associated CALD in southwestern Nigeria.
Main Methods:
- Sera from 31 Nigerian patients with chronic liver disease were tested for HDV.
- Hepatitis B surface antigen (HBsAg) and HDV antigen (HDVAg) were tested in sera from blood donors and university freshmen.
- Liver biopsies from 28 patients were stained for HDVAg.
Main Results:
- HDV antigen (HDVAg) was detected in 6.5% of patients with chronic liver disease.
- HBsAg prevalence was 12% in blood donors and 8% in university freshmen.
- No HDVAg was found in the healthy control groups, and all liver biopsies were negative for HDVAg.
Conclusions:
- The prevalence of HDV is low in southwestern Nigeria.
- HDV appears to play a minor role in the pathogenesis of HBsAg-associated chronic liver disease in this population.
- Further research is needed to understand the complex epidemiology of HDV in sub-Saharan Africa.
Abstract:
Hepatitis B virus (HBV) is strongly associated with an aggressive type of chronic active liver disease (CALD) and hepatocellular carcinoma, which tend to present in the relatively young, in sub-Saharan Africa. It is known that co-existent infection with HDV tends to aggravate the course of HBV-associated liver disease. This study was carried out to determine the sero-prevalence of hepatitis D virus (HDV) among thirty one consecutive southwestern Nigerians with HBsAg-positive, HCV antibody-negative chronic liver disease. Alongside, we tested for HBsAg and the HDV antigen in fifty randomly selected sera each from blood donors and university freshmen undergoing pre-admission medical tests and who had no clinical evidence of liver disease. The HDV antigen (HDVAg) was found in the sera of two of 31 (6.5%) patients. Among the blood donors and university freshmen, HBsAg prevalence was twelve and eight per cent respectively, while HDVAg was present in none. In addition, liver biopsies of 28 other patients were stained for HDVAg. None of these was positive. These findings show that HDV prevalence is low in our community, and suggest that the virus might play only a minor role in the pathogenesis of HBsAg-associated chronic liver disease among our patients. A review of reports on the epidemiology of HDV in sub-Saharan Africa shows a rather complicated pattern that makes its impact on HBsAg-associated CALD difficult to assess. More studies designed to elucidate this pattern of HDV epidemiology are called for.