title: Absence of hepatitis delta infection in a large rural HIV cohort in Tanzania.
abstract: OBJECTIVE
  The epidemiological and clinical determinants of hepatitis delta virus (HDV) infection in Sub-Saharan Africa are ill-defined. The prevalence of HDV infection was determined in HIV/hepatitis B virus (HBV) co-infected individuals in rural Tanzania.
  
  
  METHODS
  All HBV-infected adults under active follow-up in the Kilombero and Ulanga Antiretroviral Cohort (KIULARCO) were screened for anti-HDV antibodies. For positive samples, a second serological test and nucleic acid amplification were performed. Demographic and clinical characteristics at initiation of antiretroviral therapy (ART) were compared between anti-HDV-negative and -positive patients.
  
  
  RESULTS
  Among 222 HIV/HBV co-infected patients on ART, 219 (98.6%) had a stored serum sample available and were included in the study. Median age was 37 years, 55% were female, 46% had World Health Organization stage III/IV HIV disease, and the median CD4 count was 179 cells/μl. The prevalence of anti-HDV positivity was 5.0% (95% confidence interval 2.8-8.9%). There was no significant predictor of anti-HDV positivity. HDV could not be amplified in any of the anti-HDV-positive patients and the second serological test was negative in all of them.
  
  
  CONCLUSIONS
  No confirmed case of HDV infection was found among over 200 HIV/HBV co-infected patients in Tanzania. As false-positive serology results are common, screening results should be confirmed with a second test.
authors.affiliation: Department of Infectious Diseases, Bern University Hospital, University of Bern, CH-3010 Bern, Switzerland.
authors.forename: Annja
authors.initials: A
authors.lastname: Winter
authors.affiliation: Swiss Tropical and Public Health Institute, Basel, Switzerland; Ifakara Health Institute, Ifakara, United Republic of Tanzania; ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain.
authors.forename: Emilio
authors.initials: E
authors.lastname: Letang
authors.affiliation: Ifakara Health Institute, Ifakara, United Republic of Tanzania.
authors.forename: Aneth
authors.initials: A
authors.lastname: Vedastus Kalinjuma
authors.affiliation: Ifakara Health Institute, Ifakara, United Republic of Tanzania.
authors.forename: Namvua
authors.initials: N
authors.lastname: Kimera
authors.affiliation: Ifakara Health Institute, Ifakara, United Republic of Tanzania.
authors.forename: Alex
authors.initials: A
authors.lastname: Ntamatungiro
authors.affiliation: Swiss Tropical and Public Health Institute, Basel, Switzerland.
authors.forename: Tracy
authors.initials: T
authors.lastname: Glass
authors.affiliation: Division of Gastroenterology and Hepatology, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland.
authors.forename: Darius
authors.initials: D
authors.lastname: Moradpour
authors.affiliation: Institute of Microbiology, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland.
authors.forename: Roland
authors.initials: R
authors.lastname: Sahli
authors.affiliation: Hôpitaux Universitaires Paris-Seine-Saint-Denis, Paris, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Le Gal
authors.affiliation: Department of Infectious Diseases, Bern University Hospital, University of Bern, CH-3010 Bern, Switzerland.
authors.forename: Hansjakob
authors.initials: H
authors.lastname: Furrer
authors.affiliation: Department of Infectious Diseases, Bern University Hospital, University of Bern, CH-3010 Bern, Switzerland; Department of Infectious Diseases, University of Dakar, Dakar, Senegal; Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland. Electronic address: gilles.wandeler@ispm.unibe.ch.
authors.forename: Gilles
authors.initials: G
authors.lastname: Wandeler
mesh_terms: D000328:Adult; D015331:Cohort Studies; D060085:Coinfection; D003710:Demography; D005189:False Positive Reactions; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology; D006508:Hepatitis Antibodies / Q000097:blood*; D006509:Hepatitis B / Q000150:complications* / Q000453:epidemiology; D003699:Hepatitis D / Q000453:epidemiology*; D003698:Hepatitis Delta Virus / Q000276:immunology*; D006801:Humans; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D012424:Rural Population; D013636:Tanzania / Q000453:epidemiology
chemical_list: D006508:Hepatitis Antibodies
keywords: False-positive serology; HIV; Hepatitis delta; Sub-Saharan Africa; Tanzania