Wembulua Bruce Shinga, Le Gal Fredéric, Ndiaye Ousseynou, Pandi Melissa Sandrine, Akotia Messan Kodzo, Badiane Aboubakar Sidick, Hamouda Poussyina, Tine Judicaël, Ndiaye Kiné, Béguelin Charles, Ngom Ndeye Fatou, Wandeler Gilles, Seydi Moussa, Mena Adrià Ramírez
Service de Maladies Infectieuses et Tropicales, Fann University Hospital, Dakar, Senegal.
Centre National de Référence des Hépatites Virales B, C et Delta, Laboratoire de Microbiologie clinique, Hôpital Avicenne, Assistance Publique Hôpitaux de Paris, Sorbonne Université, Paris Cité, Bobigny, France.
Liver Int. 2025 Mar;45(3):e70026. doi: 10.1111/liv.70026.
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.
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.
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.
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.
在西非，乙型肝炎病毒（HBV）感染者中丁型肝炎病毒（HDV）感染的流行情况及其对肝脏相关并发症的影响尚不明确。我们对塞内加尔一个大型城市HBV队列进行检测，以确定是否存在HDV/HBV合并感染，并评估其与肝纤维化的关联。
我们纳入了自2019年起参加SEN-B队列且乙型肝炎表面抗原（HBsAg）呈阳性的患者。使用抗HD Diasorin LiaisonXL检测法检测抗HDV抗体（HDVAb），采用逆转录定量聚合酶链反应（RT-qPCR）检测HDV RNA，并通过测序确定基因分型。我们使用多变量逻辑回归来评估HDVAb阳性与肝纤维化之间的关联，肝纤维化定义为肝脏硬度测量值>7.0kPa。
我们分析了914名个体，中位年龄为32岁（四分位间距[IQR]26 - 41），其中487名（53.3%）为男性，117名（12.8%）合并感染HIV。13名参与者（1.4%，95%置信区间0.8 - 2.4）HDVAb检测呈阳性，其中8/13（61.5%）检测到HDV RNA。75.0%的病例中发现HDV基因型5。在多变量分析中，HDVAb阳性（调整后比值比[aOR]为11.7，95%置信区间3.1 - 45.7）、男性（aOR为5.4，95%置信区间3.1 - 10.3）、丙氨酸氨基转移酶（ALT）>40IU/L（aOR为4.4，95%置信区间2.4 - 8.2）和HBeAg阳性（aOR为4.6，95%置信区间1.8 - 11.9）与肝纤维化独立相关。
在达喀尔的HBV感染者中，HDV感染的患病率较低，但感染者出现肝硬化的风险非常高。塞内加尔迫切需要努力改善HDV筛查和管理。
