2013-10-18Zeitschriftenartikel DOI: 10.1371/journal.pone.0078094
High Prevalence and Significance of Hepatitis D Virus Infection among Treatment-Naïve HBsAg-Positive Patients in Northern Vietnam
Sy, Bui Tien
Ratsch, Boris A.
Toan, Nguyen Linh
Song, Le Huu
Nguyen, Hung Minh
Luong, Hoang Van
Velavan, Thirumalaisamy P.
Kremsner, Peter G.
Background: Hepatitis D virus (HDV) infection is considered to cause more severe hepatitis than hepatitis B virus (HBV) monoinfection. With more than 9.5 million HBV-infected people, Vietnam will face an enormous health burden. The prevalence of HDV in Vietnamese HBsAg-positive patients is speculative. Therefore, we assessed the prevalence of HDV in Vietnamese patients, determined the HDV-genotype distribution and compared the findings with the clinical outcome. Methods: 266 sera of well-characterized HBsAg-positive patients in Northern Vietnam were analysed for the presence of HDV using newly developed HDV-specific RT-PCRs. Sequencing and phylogenetic analysis were performed for HDV-genotyping. Results: The HDV-genome prevalence observed in the Vietnamese HBsAg-positive patients was high with 15.4% while patients with acute hepatitis showed 43.3%. Phylogenetic analysis demonstrated a predominance of HDV-genotype 1 clustering in an Asian clade while HDV-genotype 2 could be also detected. The serum aminotransferase levels (AST, ALT) as well as total and direct bilirubin were significantly elevated in HDV-positive individuals (p
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