A study on prevalence of HDV, HCV and HIV infection among Hepatitis B surface antigen positive patients in a tertiary care hospital.

Abstract

Hepatitis delta virus(HDV) is a defective RNA virus dependent on Hepatitis B virus(HBV) infection for its replication and expression. HBV-HDV co-infection may lead to more severe acute disease and higher risks of fulminant hepatitis, cirrhosis, and hepatocellular carcinoma. HBVHCV and HBV HIV  Coinfections are also of primary concern as they can lead to more severe liver disease especially an increased risk for  progression to liver cancer and the risk of reactivation of latent HBV infections respectively. The aim of the present study is to determine the prevalence of hepatitis D virus, Hepatitis C virus and Human Immunodeficiency virus co-infection among  hepatitis B surface antigen (HBsAg) positive  patients. Methods This is a cross sectional study conducted in the Institute of Microbiology, RGGGH, MMC, Chennai during the period of July2014 to December 2014. Blood samples were collected from HBsAg positive patients (by rapid method) and were tested by Enzyme Linked Immunosorbent Assay. The sera which were positive for HBsAg by both Immunochromatography and ELISA were tested for anti-HDV IgM and IgG anti -HCV IgM by ELISA and anti HIV-1 and 2 antibodies were tested by one step HIV 1HIV2 test ,Comb AIDS-RS and Signal HIV                   Immunodot. Results All 100 samples which were positive for HBsAg by rapid device were found to be positive for HBsAg by enzyme linked immunosorbant assay(ELISA). The mean age of these HBsAg positive patients was 45.92years. Of these  patients, 79 (79 patients) were males and 21( 21 patients) were females. Among these 100 HBsAg patients one(1) was detected to be anti-HDV antibody positive,3 patients(3) were detected to have anti- HCV antibody and 1 patient (1) was detected to have anti HIV-1 antibody positivity. Totally 5 patients had dual infections and none of the patients had triple  infections. Conclusion This study recommends a routine  evaluation of HDV, HCV and HIV markers in all patients              detected with HBsAg positivity. This evaluation would lead to early management of the co-infections also thus preventing rapid progression of liver disease and hence decrease the           morbidity and mortality.