title: Hepatitis delta in HIV/HBV co-infected patients in Brazil: is it important?
abstract: OBJECTIVE
  This study was carried out to evaluate the prevalence of hepatitis delta virus (HDV) among human immunodeficiency virus (HIV)/hepatitis B virus (HBV) co-infected patients from São Paulo, in the Southeast Region of Brazil.
  
  
  METHODS
  A total of 3259 HIV patients with serological markers for HBV were initially enrolled in the study. Among these patients, 154 (4.7%) were hepatitis B surface antigen (HBsAg)-reactive. Serum samples were obtained from 86 HBsAg-positive patients and were submitted to anti-HDV serological assay.
  
  
  RESULTS
  One (1.2%) HIV/HBV patient was found to be anti-HDV-positive, and the HDV infection was confirmed by PCR. Phylogenetic analysis showed that this HDV sequence grouped with other HDV genotype 1 sequences from Mediterranean European countries, suggesting that this virus has a common ancestor with HDV from that region. This patient was probably infected by sexual transmission, as he reported unprotected sexual intercourse with multiple partners over the course of many years but denied intravenous drug use or any travel to the Brazilian Amazon, an area known to have a high HDV prevalence.
  
  
  CONCLUSIONS
  HDV infection is infrequent in the Southeast Region of Brazil, however there have been a few cases in this region. HIV/HBV patients are at potential risk for HDV infection, therefore investigations for the presence of HDV infection must be carried out in these patients.
authors: Infectious Diseases Research Unit, ABC Medical School, Santo Andre, Brazil.
authors: Maria Cássia
authors: MC
authors: Mendes-Correa
authors: Michele S
authors: MS
authors: Gomes-Gouvêa
authors: Mónica V
authors: MV
authors: Alvarado-Mora
authors: Mariliza H
authors: MH
authors: Da Silva
authors: Carolina
authors: C
authors: Lázari
authors: Norma C S
authors: NC
authors: Cavalcanti
authors: Flaviane K
authors: FK
authors: Alonso
authors: Cátia C
authors: CC
authors: Carpinelli
authors: David E
authors: DE
authors: Uip
authors: João R R
authors: JR
authors: Pinho
mesh_terms: D000328:Adult; D001938:Brazil / Q000453:epidemiology; D060085:Coinfection; D003430:Cross-Sectional Studies; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000453:epidemiology* / Q000276:immunology / Q000821:virology; D006509:Hepatitis B / Q000453:epidemiology* / Q000276:immunology / Q000821:virology; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000235:genetics / Q000276:immunology* / Q000302:isolation & purification; D003699:Hepatitis D / Q000453:epidemiology* / Q000276:immunology / Q000635:transmission / Q000821:virology; D003698:Hepatitis Delta Virus / Q000145:classification / Q000235:genetics / Q000276:immunology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010802:Phylogeny; D015995:Prevalence; D012189:Retrospective Studies; D017422:Sequence Analysis, DNA
chemical_list: D006514:Hepatitis B Surface Antigens