TY - JOUR
T1 - Characterization of hepatitis B and delta coinfection in Israel
AU - Shirazi, Rachel
AU - Ram, Daniela
AU - Rakovsky, Aviya
AU - Bucris, Efrat
AU - Gozlan, Yael
AU - Lustig, Yaniv
AU - Shaked-Mishan, Pninit
AU - Picard, Orit
AU - Shemer-Avni, Yonat
AU - Ben-Zvi, Haim
AU - Halutz, Ora
AU - Lurie, Yoav
AU - Veizman, Ella
AU - Carlebach, Matthias
AU - Braun, Marius
AU - Naftaly, Michal Cohen
AU - Shlomai, Amir
AU - Safadi, Rifaat
AU - Mendelson, Ella
AU - Sklan, Ella H.
AU - Ben-Ari, Ziv
AU - Mor, Orna
N1 - Publisher Copyright:
© 2018 The Author(s).
PY - 2018/2/27
Y1 - 2018/2/27
N2 - Background: Characteristics of hepatitis B (HBV) and delta (HDV) coinfection in various geographical regions, including Israel, remain unclear. Here we studied HDV seroprevalence in Israel, assessed HDV/HBV viral loads, circulating genotypes and hepatitis delta antigen (HDAg) conservation. Methods: Serological anti HDV IgG results from 8969 HBsAg positive individuals tested in 2010-2015 were retrospectively analyzed to determine HDV seroprevalence. In a cohort of HBV/HDV coinfected (n=58) and HBV monoinfected (n=27) patients, quantitative real-time PCR (qRT-PCR) and sequencing were performed to determine viral loads, genotypes and hepatitis delta antigen (HDAg) protein sequence. Results: 6.5% (587/8969) of the HBsAg positive patients were positive for anti HDV antibodies. HDV viral load was >2 log copies/ml higher than HBV viral load in most of the coinfected patients with detectable HDV RNA (86%, 50/58). HDV genotype 1 was identified in all patients, most of whom did not express HBV. While 66.6% (4/6) of the HBV/HDV co-expressing patients carried HBV-D2 only 18.5% (5/27) of the HBV monoinfections had HBV-D2 (p=0.03). Higher genetic variability in the HDAg protein sequence was associated with higher HDV viral load. Conclusions: The overall significant prevalence of HDV (6.5%) mandates HDV RNA testing for all coinfected patients. Patients positive for HDV RNA (characterized by low HBV DNA blood levels) carried HDV genotype 1. Taken together, the significant HDV seroprevalence and the lack of effective anti-HDV therapy, necessitates strict clinical surveillance especially in patients with higher HDV viral loads and increased viral evolution.
AB - Background: Characteristics of hepatitis B (HBV) and delta (HDV) coinfection in various geographical regions, including Israel, remain unclear. Here we studied HDV seroprevalence in Israel, assessed HDV/HBV viral loads, circulating genotypes and hepatitis delta antigen (HDAg) conservation. Methods: Serological anti HDV IgG results from 8969 HBsAg positive individuals tested in 2010-2015 were retrospectively analyzed to determine HDV seroprevalence. In a cohort of HBV/HDV coinfected (n=58) and HBV monoinfected (n=27) patients, quantitative real-time PCR (qRT-PCR) and sequencing were performed to determine viral loads, genotypes and hepatitis delta antigen (HDAg) protein sequence. Results: 6.5% (587/8969) of the HBsAg positive patients were positive for anti HDV antibodies. HDV viral load was >2 log copies/ml higher than HBV viral load in most of the coinfected patients with detectable HDV RNA (86%, 50/58). HDV genotype 1 was identified in all patients, most of whom did not express HBV. While 66.6% (4/6) of the HBV/HDV co-expressing patients carried HBV-D2 only 18.5% (5/27) of the HBV monoinfections had HBV-D2 (p=0.03). Higher genetic variability in the HDAg protein sequence was associated with higher HDV viral load. Conclusions: The overall significant prevalence of HDV (6.5%) mandates HDV RNA testing for all coinfected patients. Patients positive for HDV RNA (characterized by low HBV DNA blood levels) carried HDV genotype 1. Taken together, the significant HDV seroprevalence and the lack of effective anti-HDV therapy, necessitates strict clinical surveillance especially in patients with higher HDV viral loads and increased viral evolution.
KW - HBV genotype
KW - HBV/HDV viral load
KW - HDV genotype
KW - Hepatitis B (HBV)
KW - Hepatitis delta (HDV)
KW - Seroprevalence
UR - http://www.scopus.com/inward/record.url?scp=85042565641&partnerID=8YFLogxK
U2 - 10.1186/s12879-018-3008-x
DO - 10.1186/s12879-018-3008-x
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AN - SCOPUS:85042565641
SN - 1471-2334
VL - 18
JO - BMC Infectious Diseases
JF - BMC Infectious Diseases
IS - 1
M1 - 97
ER -