title: Seroepidemiology and clinical features of hepatitis delta among HBsAg carriers: a study from Hepatitis Clinic of Iranian Blood Transfusion Organization.
abstract: BACKGROUND
  Hepatitis B is a significant health problem and more than 350 million individuals are infected with hepatitis B virus (HBV) globally. About 5% of these individuals are coinfected with hepatitis D virus (HDV). HBV-HDV coinfection increases the rate of fulminant hepatitis, chronic hepatitis and cirrhosis. This study aimed to evaluate the epidemiology of HDV in individuals positive for hepatitis B surface antigen (HBsAg) who were referred to Tehran Blood Transfusion Hepatitis Clinic from 2011 to 2012.
  
  
  METHODS
  HBsAg-positive individuals attending this clinic were tested for anti-HDAg antibodies (anti-HDAbs). All samples positive for anti-HDAb were also tested for detection of HDV RNA by reverse transcription-polymerase chain reaction (RT-PCR). A questionnaire consisting of demographic characteristics and potential risk factors for acquisition of HDV was filled for each individual.
  
  
  RESULTS
  Among 1038 individuals, HBsAg was detected in 660 (63.6%) cases following blood donation and in 378 (36.4%) cases following blood testing. In this study, 23 [2.2%, 95% confidence interval (CI) = 1.3-3.2%] patients were HDV-seropositive. In HDV-seropositive patients, 14 (60.9%, 95% CI = 39.1-78.3%) were positive for HDV RNA. HDV-seropositive cases were more likely to have evidence of severe forms of hepatitis than the group of individuals without anti-HDAb (P < 0.01). Familial history of hepatitis D infection was more observed in HDV-seropositive patients than in individuals negative for anti-HDAb (P < 0.01).
  
  
  CONCLUSIONS
  The seroprevalence of HDV in HBsAg-positive individuals in this study was about 2% which seems to be lower than the global prevalence of HDV.
authors.affiliation: Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine; Hepatitis Clinic, Tehran Blood Transfusion Center; Middle East Liver Disease (MELD) Center; Iran Hepatitis Network.
authors.forename: M
authors.initials: M
authors.lastname: Keshvari
authors.forename: S M
authors.initials: SM
authors.lastname: Alavian
authors.forename: B
authors.initials: B
authors.lastname: Aghaee
authors.forename: B
authors.initials: B
authors.lastname: Behnava
authors.forename: M
authors.initials: M
authors.lastname: Mahdavi
authors.forename: M Gholami
authors.initials: MG
authors.lastname: Fesharaki
authors.forename: H
authors.initials: H
authors.lastname: Sharafi
mesh_terms: D000328:Adult; D000368:Aged; D001782:Blood Donors; D060085:Coinfection / Q000097:blood / Q000453:epidemiology; D005260:Female; D006509:Hepatitis B / Q000097:blood / Q000453:epidemiology; D006514:Hepatitis B Surface Antigens / Q000097:blood*; D003699:Hepatitis D / Q000097:blood / Q000453:epidemiology; D003698:Hepatitis Delta Virus; D006782:Hospitals, Special; D006801:Humans; D007492:Iran; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood*; D016036:Seroepidemiologic Studies
chemical_list: D006514:Hepatitis B Surface Antigens; D012367:RNA, Viral
keywords: hepatitis B; hepatitis D; viral load