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. 2025 Mar;45(3):e70026.
doi: 10.1111/liv.70026.

Hepatitis Delta and Liver Disease Among People Living With Hepatitis B With or Without HIV Co-Infection in Senegal

Bruce Shinga Wembulua  1 , Fredéric Le Gal  2 , Ousseynou Ndiaye  3 , Melissa Sandrine Pandi  3   4 , Messan Kodzo Akotia  3 , Aboubakar Sidick Badiane  3 , Poussyina Hamouda  2 , Judicaël Tine  1 , Kiné Ndiaye  5 , Charles Béguelin  6 , Ndeye Fatou Ngom  5 , Gilles Wandeler  1   6   7 , Moussa Seydi  1 , Adrià Ramírez Mena  1   6   8 ; SEN‐B
Affiliations

Hepatitis Delta and Liver Disease Among People Living With Hepatitis B With or Without HIV Co-Infection in Senegal

Bruce Shinga Wembulua et al. Liver Int. 2025 Mar.

Abstract

Background and aims: The prevalence of hepatitis delta virus (HDV) infection among persons living with hepatitis B virus (HBV) and its impact on liver-related complications in West Africa are ill-defined. Wetested a large urban HBV cohort in Senegal for the presence of HDV/HBV co-infection and evaluated its association with liver fibrosis.

Methods: We included persons with positive hepatitis B surface antigen (HBsAg) enrolled in the SEN-B cohort since 2019. Anti-HDV antibodies (HDVAb) were tested using the Anti-HD Diasorin LiaisonXL test, HDV RNA was measured with RT-qPCR and genotyping was determined through sequencing. We used multivariable logistic regression to evaluate the association between HDVAb positivity and liver fibrosis, defined as a liver stiffness measurement > 7.0 kPa.

Results: We analysed 914 individuals with a median age of 32 years (interquartile range [IQR] 26-41), of whom 487 (53.3%) were men and 117 (12.8%) had HIV co-infection. Thirteen participants (1.4%, 95% CI 0.8-2.4) had a positive HDVAb test, of whom 8/13 (61.5%) showed detectable HDV RNA. HDV genotype 5 was found in 75.0% of cases. In multivariable analyses, HDVAb positivity (aOR 11.7, 95% CI 3.1-45.7), male sex (aOR 5.4, 95% CI 3.1-10.3), ALT > 40 IU/L (aOR 4.4, 95% CI 2.4-8.2) and HBeAg positivity (aOR 4.6, 95% CI 1.8-11.9) were independently associated with liver fibrosis.

Conclusion: The prevalence of HDV infection was low in persons living with HBV in Dakar, but those affected had a very high risk of presenting with liver cirrhosis. Efforts to improve HDV screening and management are urgently needed in Senegal.

Keywords: Senegal; hepatitis B; hepatitis D; liver fibrosis; prevalence.

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Conflict of interest statement

G.W. received research grants from Roche Diagnostics and Gilead Sciences and served on advisory boards for ViiV, Gilead Sciences and MSD. All other authors declare no conflicts of interest. The funders had no role in the design of the study; in the collection, analyses or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

FIGURE 1
FIGURE 1
HDV RNA and HBV DNA levels by HDV genotypes among individuals HDVAb positive. HBsAg: hepatitis B surface antigen, HDV: hepatitis D Virus, HDVAb: hepatitis D virus antibody, HDV‐Gt: HDV genotype, IU/mL: international units per millilitre, LLOD: lower limit of detection, LLOQ: lower limit of quantification, RN A: ribonucleic acid. All HDV RNA and HBV DNA values below the LLOQ were arbitrarily assigned a value of 0.5 log10 IU/mL.
FIGURE 2
FIGURE 2
ALT, LSM and qHBsAg levels by HDVAb status. ALT: alanine aminotransferase, HDVAb: hepatitis D virus antibody, IU/L: international units per litre, kPa: kilopascal, LSM: liver stiffness measurements, qHBsAg: quantitative hepatitis B surface antigen.
FIGURE 3
FIGURE 3
ALT (A) and LSM (B) by HDV RNA detectability status (N = 13). Each dot represents individual data. ALT: alanine aminotransferase, HDV: hepatitis D virus, HIV: human immunodeficiency virus, IU/L: international units per litre, kPa: kilopascal, log10: logarithm to base 10, LSM: liver stiffness measurements, Neg: negative, Pos: positive, RNA: ribonucleic acid.
FIGURE 4
FIGURE 4
Adjusted association of HDVAb positivity with (A) liver fibrosis (LSM > 7.0 kPa) and (B) cirrhosis (LSM > 11.0 kPa). ALT: alanine aminotransferase, aOR: adjusted odds ratio, BMI: body mass index, CI: confidence interval, HBeAg, hepatitis B envelope antigen, HDVAb: hepatitis D virus antibody, HIV: human immunodeficiency virus, Kg/m2: kilograms per square metre, LSM, liver stiffness measurement.
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