Population-based comparative epidemiological survey of hepatitis B, D, and C among Inuit migrated to Denmark and in high endemic Greenland.
OBJECTIVE
Infection with hepatitis B virus (HBV) is endemic among Arctic populations where it may have a benign course. However, the relation of HBV to migration to low endemic areas is unknown, as it is for hepatitis D and C, and details on the influence of delta virus at a population level are lacking.


METHODS
Population-based investigation of Greenlanders living in Denmark (n = 136) and in Greenland (n = 441). We tested for HBsAg, anti-HBs, anti-HBc, HBeAg, anti-HBe, HBV-DNA, HBV genotypes, anti-HDV, HDV-RNA, anti-HCV, HCV-Elisa test, HCV-RNA, aspartate aminotransferase, gamma-glutamyl transferase, bilirubin, and albumin, and performed a physical examination.


RESULTS
Participation rate was 52/95% in Denmark/Greenland. Half of participants in Denmark had lived more than half of their lives in Denmark, and 54.5% had been exposed to HBV. This was similar to 53% among Greenlanders living in West Greenland (p = 0.76). HBsAg was positive in 4.4% of Greenlanders in Denmark (n = 6), who all were anti-HBe positive and had low viral load. Serological signs of HBV infection associated with having both parents born in Greenland (p = 0.007) and with IV drug use (p = 0.03). We found serological signs of HDV exposure among participants in Denmark/Greenland in 0.7/1.1% (n = 1/5) and HCV exposure in 1.5/0.0% (n = 2/0). Liver biochemistry was elevated in Greenlanders exposed to HDV.


CONCLUSIONS
Hepatitis B, D, and C occurrences among Greenlanders in Denmark mirrored that of Greenland. Importantly, previously undetected exposure to delta virus associated with elevated liver biochemistry, and the introduction of delta virus is a liability to Greenlanders and to Greenland.
Department of Internal Medicine, Queen Ingrid's Hospital, Nuuk, Greenland. karsten_rex@hotmail.com
Karsten Fleischer
KF
Rex
Henrik B
HB
Krarup
Peter
P
Laurberg
Stig
S
Andersen
D000328:Adult; D000368:Aged; D004279:DNA, Viral / Q000032:analysis; D003718:Denmark / Q000453:epidemiology; D054242:Emigrants and Immigrants; D019353:Endemic Diseases; D005260:Female; D006116:Greenland / Q000453:epidemiology / Q000208:ethnology; D016174:Hepacivirus / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification; D006508:Hepatitis Antibodies / Q000097:blood; D018963:Hepatitis Antigens / Q000097:blood; D006509:Hepatitis B / Q000097:blood / Q000208:ethnology* / Q000821:virology; D006515:Hepatitis B virus / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification; D006526:Hepatitis C / Q000097:blood / Q000208:ethnology* / Q000821:virology; D003699:Hepatitis D / Q000097:blood / Q000208:ethnology* / Q000821:virology; D003698:Hepatitis Delta Virus / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification; D006801:Humans; D004930:Inuit; D008297:Male; D008875:Middle Aged; D020133:Reverse Transcriptase Polymerase Chain Reaction; D016036:Seroepidemiologic Studies; D019562:Viral Load
D004279:DNA, Viral; D006508:Hepatitis Antibodies; D018963:Hepatitis Antigens