Chronic hepatitis delta virus infection in Van region of eastern Turkey

Abstract

Background/aims: Hepatitis delta virus infection is an important cause of liver morbidity and mortality worldwide. In Eastern Turkey, hepatitis B virus infection is the major cause of chronic liver diseases. We aimed to research the role of hepatitis delta virus infection in chronic liver diseases related to hepatitis B virus infection in the Van region of Eastern Turkey.

Methods: Serological markers of hepatitis B virus and hepatitis delta virus infection [HBsAg, HbeAg, Anti-HBe and Anti- hepatitis delta virus total (IgM+IgG)] were determined by ELISA test in patients with chronic hepatitis and cirrhosis. Serum hepatitis B virus DNA was determined by polymerase chain reaction (PCR) method in chronic hepatitis B patients.

Results: Hepatitis delta virus infection was detected in 5% (7/138) of asymptomatic hepatitis B virus carriers, in 16% (24/148) of chronic hepatitis B patients and in 45% (34/75) of cirrhotic hepatitis B virus patients. hepatitis delta virus infection showed a three-fold increase in chronic hepatitis (p<0.01) and nine-fold increase in cirrhosis (p<0.001) compared to hepatitis delta virus carriers. Also, it was three times more frequent in cirrhosis (p<0.001) compared to chronic hepatitis. Chronic hepatitis delta virus infection was equally distributed between sexes in patients with chronic hepatitis B virus infection, whereas chronic hepatitis B virus infection alone was three times more frequent in males (p<0.001). Mean ages of hepatitis delta virus carriers, chronic hepatitis D and hepatitis delta virus cirrhosis patients were 30.7+/-8 (14-65), 36+/-13 (19-70) and 44 +/-16 (25-55), respectively.

Conclusions: The higher prevalence of hepatitis delta virus infection in more severe form of hepatitis B virus infection suggests that hepatitis delta virus infection increases the severity of chronic hepatitis B virus infection in the Van region. hepatitis delta virus infection remains a second major cause of chronic liver diseases in Eastern Turkey in spite of its decreasing prevalence in Western countries and in Western Turkey.