title: Hepatitis Delta Virus Infection in Romania: Prevalence and Risk Factors.
abstract: BACKGROUND
  Hepatitis delta virus (HDV) infection is associated with accelerated progression of fibrosis, early occurrence of hepatic decompensation and an increased risk for hepatocellular carcinoma. Epidemiological data on hepatitis delta virus (HDV) in Romania are still lacking.
  
  
  OBJECTIVE
  To assess the prevalence, virological, clinical and epidemiological features of HDV infection in Romanian patients.
  
  
  METHODS
  We conducted a multicenter study in 10 centers. Data on sociodemographic characteristics and potential risk factors were collected through a questionnaire. Virological markers of HBV and HDV infection, biochemical and clinical features of liver disease were evaluated.
  
  
  RESULTS
  The study population comprised 2,761 HBsAg(+) patients with a mean age of 43.8+/-13.8 years, out of whom 5.2% were HBeAg(+) and 55.7% were males. Liver cirrhosis was detected in 17.9% of patients, while 80.4% had chronic hepatitis. The prevalence of IgG anti-HDV(+) patients was 23.1%, out of whom 16.4% were HDV RNA positive. The highest prevalence of HDV infection was encountered in patients aged 50-59 years (28.9%) and patients aged >/= 60 (24.8%) (p=0.0001). Seroprevalence of HDV was significantly higher in AgHBs(+) cirrhotics vs. noncirrhotics (43.4% vs 19.0%, p=0.0001). Risk factors for HDV infection were: occupational hazard, no HCV chronic infection, lack of anti-HBV vaccination, presence of blood transfusions, any previous surgery, frequent hospitalization or endoscopies, tattoos, body piercing, use of glass syringes, number of female sexual partners.
  
  
  CONCLUSIONS
  HBsAg(+) population in Romania is characterized by a high prevalence of HBeAg(-) HBV infection as well as HDV co-infection. A cohort phenomenon for HDV prevalence is also observed similar to that of HCV/HBV monoinfections.
authors.affiliation: Center Digestive Diseases and Liver Transplantation, Fundeni Clinical Institute, Bucharest, Romania. drlgheorghe@gmail.com.
authors.forename: Liana
authors.initials: L
authors.lastname: Gheorghe
authors.affiliation: National Institute of Public Health, Bucharest, Romania.
authors.forename: Irma Eva
authors.initials: IE
authors.lastname: Csiki
authors.affiliation: Center Digestive Diseases and Liver Transplantation, Fundeni Clinical Institute, Bucharest, Romania.
authors.forename: Speranta
authors.initials: S
authors.lastname: Iacob
authors.affiliation: Center Digestive Diseases and Liver Transplantation, Fundeni Clinical Institute, Bucharest, Romania.
authors.forename: Cristian
authors.initials: C
authors.lastname: Gheorghe
authors.affiliation: Center Gastroenterology and Hepatology, Iasi, Romania. stanciucarol@yahoo.com.
authors.forename: Anca
authors.initials: A
authors.lastname: Trifan
authors.affiliation: Institute Gastroenterology and Hepatology Cluj Napoca, Romania.
authors.forename: Mircea
authors.initials: M
authors.lastname: Grigorescu
authors.affiliation: Victor Babes Universitary Hospital of Infectious and Tropical Diseases, Bucharest, Romania.
authors.forename: Adriana
authors.initials: A
authors.lastname: Motoc
authors.affiliation: Clinic Gastroenterology and Hepatology, University of Medicine and Pharmacy, Constanta, Romania.
authors.forename: Andra
authors.initials: A
authors.lastname: Suceveanu
authors.affiliation: University Hospital Infectious Diseases, Timisoara, Romania.
authors.forename: Manuela
authors.initials: M
authors.lastname: Curescu
authors.affiliation: National Institute Infectious Diseases Matei Bals, Bucharest, Romania.
authors.forename: Florin
authors.initials: F
authors.lastname: Caruntu
authors.affiliation: Center Gastroenterology and Hepatology, University of Medicine and Pharmacy, Timisoara, Romania.
authors.forename: Ioan
authors.initials: I
authors.lastname: Sporea
authors.affiliation: Clinic Gastroenterology Hepatology, Oradea, Romania.
authors.forename: Ciprian
authors.initials: C
authors.lastname: Brisc
authors.affiliation: Clinic Gastroenterology Hepatology, University of Medicine and Pharmacy, Craiova, Romania.
authors.forename: Ion
authors.initials: I
authors.lastname: Rogoveanu
authors.affiliation: Center Digestive Diseases and Liver Transplantation, Fundeni Clinical Institute, Bucharest, Romania.
authors.forename: Razvan
authors.initials: R
authors.lastname: Cerban
authors.affiliation: Center Digestive Diseases and Liver Transplantation, Fundeni Clinical Institute, Bucharest, Romania.
authors.forename: Letitia
authors.initials: L
authors.lastname: Tugui
authors.affiliation: Hoffmann La Roche, Bucharest, Romania.
authors.forename: Andrea
authors.initials: A
authors.lastname: Alexandrescu
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D060085:Coinfection; D005260:Female; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006513:Hepatitis B e Antigens / Q000097:blood; D019694:Hepatitis B, Chronic / Q000175:diagnosis / Q000453:epidemiology* / Q000635:transmission / Q000821:virology; D003699:Hepatitis D / Q000175:diagnosis / Q000453:epidemiology* / Q000635:transmission / Q000821:virology; D003698:Hepatitis Delta Virus / Q000302:isolation & purification; D006801:Humans; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000453:epidemiology / Q000821:virology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012383:Romania / Q000453:epidemiology; D016036:Seroepidemiologic Studies; D055815:Young Adult
chemical_list: D015415:Biomarkers; D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens