Co-Infection of Hepatitis B Virus and Hepatitis Delta Virus in Yaounde-Cameroon

Aims: To determine the seroprevalence of HDV as well as the virological and clinical characteristics of HBV mono-infected and HBV/HDV co-infected patients.

Study Design: The few studies on HDV in Cameroon have reported a high prevalence of this viral infection. This is a first step in describing the virological and clinical profile of HBV mono-infected and of HBV/HDV co-infected patients.

Place and Duration of Study: Blood collection was carried out in the Gastroenterology Unit of the Yaounde University Hospital Centre, Yaounde General Hospital and “Centre Médical la Cathédrale”, from August 2012 to May 2013.

Methodology: We included into this study treatment-naïve HBV-infected patients from Yaounde irrespective of age and gender free of HIV and HCV infection. Blood samples were collected from each patient for laboratory analysis. Detection of HDV antibodies (Diasorin, Germany) was performed by ELISA and viral load for HBV and HDV was determined using real-time PCR (Abbott Molecular Diagnostics). Patients were classified clinically into low replicative hepatitis, immune tolerance and chronic active hepatitis. Moreover, ultrasound and liver histological data were collected.

Results: The population comprised 128 chronic HBV-infected patients of which 77 (60.16%) were male and 51 (39.84%) were female. We found 29 HDV-positive patients representing 22.66% of the population. In the HBV/HDV co-infected group, the mean viral load for HBV was significantly low compared to patients with HBV mono-infection (P = .01). These patients also presented with higher liver cytolysis compared to HBV mono-infected patients (P<.001). Chronic active hepatitis was significantly more prevalent in HBV/HDV co-infected patients (68.96%) compared to HBV mono-infected patients (20.20%).

Conclusion: We found that HBV/HDV co-infection results in suppression of HBV replication and such patients show broader sequelae of liver disease. The prevalence of HBV and HDV co-infection is high in this population. Routine screening of HBV-positive individuals for HDV should be implemented in the health services nationwide.