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Transfus Med. 2014 Dec;24(6):411-7. doi: 10.1111/tme.12163. Epub 2014 Dec 18.

Seroepidemiology and clinical features of hepatitis delta among HBsAg carriers: a study from Hepatitis Clinic of Iranian Blood Transfusion Organization.

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Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine; Hepatitis Clinic, Tehran Blood Transfusion Center; Middle East Liver Disease (MELD) Center; Iran Hepatitis Network.



Hepatitis B is a significant health problem and more than 350 million individuals are infected with hepatitis B virus (HBV) globally. About 5% of these individuals are coinfected with hepatitis D virus (HDV). HBV-HDV coinfection increases the rate of fulminant hepatitis, chronic hepatitis and cirrhosis. This study aimed to evaluate the epidemiology of HDV in individuals positive for hepatitis B surface antigen (HBsAg) who were referred to Tehran Blood Transfusion Hepatitis Clinic from 2011 to 2012.


HBsAg-positive individuals attending this clinic were tested for anti-HDAg antibodies (anti-HDAbs). All samples positive for anti-HDAb were also tested for detection of HDV RNA by reverse transcription-polymerase chain reaction (RT-PCR). A questionnaire consisting of demographic characteristics and potential risk factors for acquisition of HDV was filled for each individual.


Among 1038 individuals, HBsAg was detected in 660 (63.6%) cases following blood donation and in 378 (36.4%) cases following blood testing. In this study, 23 [2.2%, 95% confidence interval (CI) = 1.3-3.2%] patients were HDV-seropositive. In HDV-seropositive patients, 14 (60.9%, 95% CI = 39.1-78.3%) were positive for HDV RNA. HDV-seropositive cases were more likely to have evidence of severe forms of hepatitis than the group of individuals without anti-HDAb (P < 0.01). Familial history of hepatitis D infection was more observed in HDV-seropositive patients than in individuals negative for anti-HDAb (P < 0.01).


The seroprevalence of HDV in HBsAg-positive individuals in this study was about 2% which seems to be lower than the global prevalence of HDV.


hepatitis B; hepatitis D; viral load

[Indexed for MEDLINE]

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