aDivision of Molecular Virology & Molecular Diagnostics, National Centre of Excellence in Molecular Biology (CEMB), University of the Punjab bCentre for Applied Molecular Biology, Ministry of Science & Technology, Lahore, Pakistan.
Eur J Gastroenterol Hepatol. 2014 Mar;26(3):319-24. doi: 10.1097/MEG.0000000000000007.
Hepatitis delta virus (HDV) and hepatitis B virus (HBV) have been identified as major causes of morbidity and mortality in Pakistan because HDV causes infection only in the presence of HBV. Coinfection with both hepatitis viruses can lead to a more severe acute form of disease and to an increased risk of fulminant hepatitis. HDV infection differs in its distribution and severity depending on the geographical distribution, and several genotypes of HDV have been identified so far.
The aim of the present study was to establish the HDV and HBV genotypes in chronically infected Pakistani patients and to determine whether there is any correlation between HDV and HBV genotypes.
We studied samples from a total of 46 chronically infected HBV and HDV patients for HBV and HDV genotype analysis out of a total of 75 chronic HBV carriers enrolled. HBV and HDV genotypes were determined using type-specific PCR, followed by sequencing of PCR amplified products.
The results of HBV genotyping showed that 33 of 46 (71.7%) patients had genotype D, five (10.9%) had A+D mixed genotypes, whereas eight (17.3) samples were untypable. We could detect only one HDV genotype (HDV-1) prevalent in the Pakistani population. The HDV-1 genotype isolate was associated with HBV genotype D alone or in combination with A (HBV-A+D).
The present study concludes that HDV/HBV coinfection is very high in the Pakistani population and was previously underestimated. The most prevalent circulating genotypes of HBV and HDV are HDV-1 and HBV-D, respectively, in the studied area. There is no specific interaction between HBV and HDV genotypes as suggested by HDV-1/HBV-D or HDV-1/HBV-A+D coinfection. Coinfection of HDV-1 and HBV-D simply reflects the most frequent genotypes circulating in this specific geographical region of the world.
乙型肝炎病毒（HBV）和δ型肝炎病毒（HDV）已被确认为导致巴基斯坦发病率和死亡率的主要原因，因为 HDV 仅在存在 HBV 的情况下引起感染。两种肝炎病毒的合并感染可导致更严重的急性疾病，并增加暴发性肝炎的风险。HDV 感染的分布和严重程度因地理位置而异，迄今为止已鉴定出几种 HDV 基因型。
本研究的目的是确定慢性感染巴基斯坦患者的 HDV 和 HBV 基因型，并确定 HDV 和 HBV 基因型之间是否存在任何相关性。
我们从总共 75 名慢性 HBV 携带者中研究了总共 46 名慢性 HBV 和 HDV 感染患者的样本，以进行 HBV 和 HDV 基因型分析。使用型特异性 PCR 确定 HBV 和 HDV 基因型，然后对 PCR 扩增产物进行测序。
HBV 基因分型结果显示，46 例患者中有 33 例（71.7％）为基因型 D，5 例（10.9％）为 A+D 混合基因型，8 例（17.3％）无法定型。我们只能检测到在巴基斯坦人群中流行的一种 HDV 基因型（HDV-1）。HDV-1 基因型分离株与 HBV 基因型 D 或与 A 联合（HBV-A+D）有关。
本研究得出的结论是，HDV/HBV 合并感染在巴基斯坦人群中非常高，此前被低估了。在研究区域，HBV 和 HDV 的最常见循环基因型分别为 HDV-1 和 HBV-D。正如 HDV-1/HBV-D 或 HDV-1/HBV-A+D 合并感染所表明的那样，HBV 和 HDV 基因型之间没有特定的相互作用。HDV-1 和 HBV-D 的合并感染仅反映了该特定地理位置最常见的基因型。
