Frequency of delta agent infections in Kuwait.

Antibodies to delta antigen have been found among all populations in the world studied so far. The prevalence is high (40%-47%) in chronic HBsAg carriers in southern Italy. In other parts of the world, the prevalence is low (less than 5%); however, 30%-75% of polytransfused hemophiliacs and drug addicts in Europe and the United States have antibodies to delta antigen [2]. Most Arab nationalities are well represented in the population of Kuwait. Among 144 HBsAg-positive sera studied, 58 (40%) were positive for antibodies to delta antigen. Data regarding diagnosis, age, sex, and nationality were available for 80 of the patients investigated. Among these, 32 (40%) were antibody-positive. The highest number of positive patients was among those with chronic liver disease; all except two of the positive patients were Gulf or Mediterranean Arabs. Thus, infection with delta agent is an important cofactor in the pathogenesis of chronic liver disease in this region, because delta agent is known to become chronic [2]. The patients who had chronic liver disease and those who had illnesses other than liver disease or acute hepatitis are probably all chronic HBsAg carriers; however, it was not possible to differentiate between chronic and transient carrier states. Some of the patients with acute hepatitis also probably carried HBsAg with a superimposed delta infection. The carriage rate of HBsAg in the normal population in Kuwait is 2.8%-4% [3]. The only fatal case of acute hepatitis in this study occurred among the patients who were positive for delta antibody.(ABSTRACT TRUNCATED AT 250 WORDS)