Research laboratory, Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana; Department of Biological Sciences, Faculty of Science, University of Botswana, Gaborone, Botswana.
Research laboratory, Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana; School of Allied Health Professions, Faculty of Health Sciences, University of Botswana, Gaborone, Botswana.
J Infect Public Health. 2023 Nov;16(11):1736-1741. doi: 10.1016/j.jiph.2023.08.011. Epub 2023 Aug 22.
Approximately 15-20 million people worldwide are infected with hepatitis delta virus (HDV), which is approximately 5 % of people with chronic hepatitis B virus (HBV). Sub-Saharan Africa has high HDV prevalence, leading to worse clinical outcomes among people who are HIV/HBV/HDV tri-infected. There are limited data on HDV prevalence among people with HIV (PWH) who are HBV-infected and uninfected in Botswana. We, therefore, determined HDV prevalence among PWH in Botswana.
This was a retrospective cross-sectional study utilizing archived plasma samples from PWH with results for HBV markers such as hepatitis B surface antigen (HBsAg), hepatitis B core antibody (anti-HBc), immunoglobulin M antibody to hepatitis B core antigen (IgM anti-HBc) and hepatitis B e antigen (HBeAg). Samples were categorized according to their HBsAg status and screened for anti-HDV antibodies. Total nucleic acid was extracted from samples with a single positive anti-HDV result, and HDV ribonucleic acid (RNA) load was quantified using the Altona Diagnostic RealStar® HDV RT-PCR kit. Statistical analysis was performed using STATA version 14.0 where p-values < 0.05 were considered statistically significant.
The study cohort (n = 478) included both HBsAg positive (44 %) and negative (56 %) participants, with a median age of 42 [IQR; 41-43]. Anti-HDV prevalence of (15/211) [7.1 %, 95 % CI: 4.4 - 11.4] was recorded among HBsAg positive participants, all of whom were IgM anti-HBc negative, while 5/6 participants were HBeAg negative. HDV RNA load was detected in 11/12 (92 %) anti-HDV-positive participants. No HDV prevalence was recorded among participants who were HBsAg negative, therefore, the overall HDV prevalence was (15/478) [3.1 %, 95 % CI: 1.9 - 5.1]. HIV viral load suppression was statistically insignificant, irrespective of HDV status.
We report high HDV prevalence among HBsAg-positive PWH in Botswana. Most HDV-positive participants had active HDV infection, therefore, we recommend HDV screening in this cohort to guide their clinical care.
全球约有 1500 万至 2000 万人感染了乙型肝炎 delta 病毒（HDV），约占慢性乙型肝炎病毒（HBV）感染者的 5%。撒哈拉以南非洲地区 HDV 流行率较高，导致 HIV/HBV/HDV 三重感染者的临床结局更差。博茨瓦纳 HIV 感染者（PWH）中，HBV 感染和未感染人群的 HDV 流行率数据有限。因此，我们确定了博茨瓦纳 PWH 中的 HDV 流行率。
这是一项回顾性横断面研究，利用博茨瓦纳 PWH 的存档血浆样本，这些样本的 HBV 标志物结果包括乙型肝炎表面抗原（HBsAg）、乙型肝炎核心抗体（抗-HBc）、乙型肝炎核心抗原免疫球蛋白 M 抗体（IgM 抗-HBc）和乙型肝炎 e 抗原（HBeAg）。根据 HBsAg 状态对样本进行分类，并筛查抗-HDV 抗体。从具有单个阳性抗-HDV 结果的样本中提取总核酸，并使用 Altona 诊断 RealStar®HDV RT-PCR 试剂盒定量测定 HDV 核糖核酸（RNA）载量。使用 STATA 版本 14.0 进行统计分析，p 值<0.05 被认为具有统计学意义。
研究队列（n=478）包括 HBsAg 阳性（44%）和阴性（56%）参与者，中位年龄为 42[四分位距；41-43]。在 HBsAg 阳性参与者中记录了（15/211）[7.1%，95%CI：4.4-11.4]的抗-HDV 流行率，他们均为 IgM 抗-HBc 阴性，而 6 名参与者中有 5 名 HBeAg 阴性。在 12 名抗-HDV 阳性参与者中的 11 名中检测到 HDV RNA 载量。在 HBsAg 阴性的参与者中未记录到 HDV 流行率，因此，总体 HDV 流行率为（15/478）[3.1%，95%CI：1.9-5.1]。无论 HDV 状态如何，HIV 病毒载量抑制均无统计学意义。
我们报告了博茨瓦纳 HBsAg 阳性 PWH 中的高 HDV 流行率。大多数 HDV 阳性参与者存在活跃的 HDV 感染，因此，我们建议在该队列中进行 HDV 筛查，以指导其临床护理。
