Institute of Tropical Medicine, University of Tübingen, 72076 Tübingen, Germany.
Vietnamese-German Center for Medical Research, VG-CARE, Hanoi, Vietnam.
Viruses. 2021 Feb 22;13(2):346. doi: 10.3390/v13020346.
Hepatitis delta virus (HDV) coinfection will additionally aggravate the hepatitis B virus (HBV) burden in the coming decades, with an increase in HBV-related liver diseases. Between 2018 and 2019, a total of 205 HBV patients clinically characterized as chronic hepatitis B (CHB; = 115), liver cirrhosis (LC; = 21), and hepatocellular carcinoma (HCC; = 69) were recruited. HBV surface antigen (HBsAg), antibodies against surface antigens (anti-HBs), and core antigens (anti-HBc) were determined by ELISA. The presence of hepatitis B viral DNA and hepatitis delta RNA was determined. Distinct HBV and HDV genotypes were phylogenetically reconstructed and vaccine escape mutations in the "a" determinant region of HBV were elucidated. All HBV patients were HbsAg positive, with 99% ( = 204) and 7% ( = 15) of them being positive for anti-HBc and anti-HBs, respectively. Anti-HBs positivity was higher among HCC (15%; = 9) compared to CHB patients. The HBV-B genotype was predominant (65%; = 134), followed by HBV-C (31%; = 64), HBV-D, and HBV-G (3%; = 7). HCC was observed frequently among young individuals with HBV-C genotypes. A low frequency (2%; = 4) of vaccine escape mutations was observed. HBV-HDV coinfection was observed in 16% ( = 33) of patients with the predominant occurrence of the HDV-1 genotype. A significant association of genotypes with alanine aminotransferase (ALT) and aspartate aminotransferase (AST) enzyme levels was observed in HBV monoinfections. The prevalence of the HDV-1 genotype is high in Vietnam. No correlation was observed between HDV-HBV coinfections and disease progression when compared to HBV monoinfections.
乙型肝炎 delta 病毒 (HDV) 合并感染将在未来几十年内加重乙型肝炎病毒 (HBV) 的负担,导致更多的 HBV 相关肝病。2018 年至 2019 年,共招募了 205 名临床特征为慢性乙型肝炎 (CHB;n=115)、肝硬化 (LC;n=21) 和肝细胞癌 (HCC;n=69) 的 HBV 患者。通过酶联免疫吸附试验 (ELISA) 测定 HBV 表面抗原 (HBsAg)、表面抗原抗体 (抗-HBs) 和核心抗原抗体 (抗-HBc)。检测乙型肝炎病毒 DNA 和乙型肝炎 delta 病毒 RNA 的存在情况。对不同的 HBV 和 HDV 基因型进行系统进化重建,并阐明 HBV 表面抗原 "a" 决定簇的疫苗逃逸突变。所有 HBV 患者 HBsAg 均为阳性,99% ( = 204) 和 7% ( = 15) 的患者抗-HBc 和抗-HBs 阳性。与 CHB 患者相比,HCC 患者抗-HBs 阳性率更高 (15%;n=9)。HBV-B 基因型占主导地位 (65%;n=134),其次是 HBV-C (31%;n=64)、HBV-D 和 HBV-G (3%;n=7)。HBV-C 基因型的 HCC 患者以年轻人为主。观察到疫苗逃逸突变的频率较低 (2%;n=4)。在 16% (n=33) 的患者中观察到 HBV-HDV 合并感染,主要为 HDV-1 基因型。在 HBV 单一感染中,基因型与丙氨酸氨基转移酶 (ALT) 和天冬氨酸氨基转移酶 (AST) 酶水平显著相关。在越南,HDV-1 基因型的流行率较高。与 HBV 单一感染相比,HDV-HBV 合并感染与疾病进展之间无相关性。