Annja Winter1, Emilio Letang2, Aneth Vedastus Kalinjuma3, Namvua Kimera3, Alex Ntamatungiro3, Tracy Glass4, Darius Moradpour5, Roland Sahli6, Frédéric Le Gal7, Hansjakob Furrer1, Gilles Wandeler8. 1. Department of Infectious Diseases, Bern University Hospital, University of Bern, CH-3010 Bern, Switzerland. 2. Swiss Tropical and Public Health Institute, Basel, Switzerland; Ifakara Health Institute, Ifakara, United Republic of Tanzania; ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain. 3. Ifakara Health Institute, Ifakara, United Republic of Tanzania. 4. Swiss Tropical and Public Health Institute, Basel, Switzerland. 5. Division of Gastroenterology and Hepatology, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland. 6. Institute of Microbiology, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland. 7. Hôpitaux Universitaires Paris-Seine-Saint-Denis, Paris, France. 8. Department of Infectious Diseases, Bern University Hospital, University of Bern, CH-3010 Bern, Switzerland; Department of Infectious Diseases, University of Dakar, Dakar, Senegal; Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland. Electronic address: gilles.wandeler@ispm.unibe.ch.
Abstract
OBJECTIVES: The epidemiological and clinical determinants of hepatitis delta virus (HDV) infection in Sub-Saharan Africa are ill-defined. The prevalence of HDV infection was determined in HIV/hepatitis B virus (HBV) co-infected individuals in rural Tanzania. METHODS: All HBV-infected adults under active follow-up in the Kilombero and Ulanga Antiretroviral Cohort (KIULARCO) were screened for anti-HDV antibodies. For positive samples, a second serological test and nucleic acid amplification were performed. Demographic and clinical characteristics at initiation of antiretroviral therapy (ART) were compared between anti-HDV-negative and -positive patients. RESULTS: Among 222 HIV/HBV co-infected patients on ART, 219 (98.6%) had a stored serum sample available and were included in the study. Median age was 37 years, 55% were female, 46% had World Health Organization stage III/IV HIV disease, and the median CD4 count was 179 cells/μl. The prevalence of anti-HDV positivity was 5.0% (95% confidence interval 2.8-8.9%). There was no significant predictor of anti-HDV positivity. HDV could not be amplified in any of the anti-HDV-positive patients and the second serological test was negative in all of them. CONCLUSIONS: No confirmed case of HDV infection was found among over 200 HIV/HBV co-infected patients in Tanzania. As false-positive serology results are common, screening results should be confirmed with a second test.
OBJECTIVES: The epidemiological and clinical determinants of hepatitis delta virus (HDV) infection in Sub-Saharan Africa are ill-defined. The prevalence of HDV infection was determined in HIV/hepatitis B virus (HBV) co-infected individuals in rural Tanzania. METHODS: All HBV-infected adults under active follow-up in the Kilombero and Ulanga Antiretroviral Cohort (KIULARCO) were screened for anti-HDV antibodies. For positive samples, a second serological test and nucleic acid amplification were performed. Demographic and clinical characteristics at initiation of antiretroviral therapy (ART) were compared between anti-HDV-negative and -positive patients. RESULTS: Among 222 HIV/HBV co-infectedpatients on ART, 219 (98.6%) had a stored serum sample available and were included in the study. Median age was 37 years, 55% were female, 46% had World Health Organization stage III/IV HIV disease, and the median CD4 count was 179 cells/μl. The prevalence of anti-HDV positivity was 5.0% (95% confidence interval 2.8-8.9%). There was no significant predictor of anti-HDV positivity. HDV could not be amplified in any of the anti-HDV-positive patients and the second serological test was negative in all of them. CONCLUSIONS: No confirmed case of HDV infection was found among over 200 HIV/HBV co-infectedpatients in Tanzania. As false-positive serology results are common, screening results should be confirmed with a second test.
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