Saudi Journal of Gastroenterology
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Year : 2017  |  Volume : 23  |  Issue : 3  |  Page : 176-182

Prevalence and molecular characterization of hepatitis D virus in Saudi Arabia: A single-center study

1 Special Infectious Agent Unit, King Fahd Medical Research Centre, King Abdulaziz University, Jeddah, Saudi Arabia
2 Special Infectious Agent Unit, King Fahd Medical Research Centre, King Abdulaziz University; Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
3 Unit of Gastroenterology and Hepatology, Department of Internal Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
4 Gastroenterology Unit, King Fahd Hospital, Jeddah, Saudi Arabia
5 Department of Medicine, King Fahd Hospital, Jeddah, Saudi Arabia
6 Gastroenterology Department, King Fahd Central Hospital, Jizan, Saudi Arabia
7 Viral Hepatitis Research Laboratory, National Hepatology and Tropical Medicine Research Institute, Cairo; Department of Microbiology and Immunology, Faculty of Medicine, Minia University, Minia, Egypt
8 Department of Medicine, Section of Gastroenterology, King Abdulaziz University Hospital, Jeddah, Saudi Arabia

Correspondence Address:
Sherif A El-Kafrawy
Special Infectious Agents Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah - 21589
Saudi Arabia
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/sjg.SJG_515_16

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Background/Aims: Hepatitis D virus (HDV) is a defective RNA virus that is dependent on hepatitis B surface antigen (HBsAg) for transmission and replication. HDV significance arises from the possibility of poor prognosis of hepatitis B virus (HBV) infection. In Saudi Arabia, HDV prevalence varied from 8 to 32% before the HBV vaccination program and ranged from 0 to 14.7% after the vaccination program was started. The last study, performed in 2004, showed a prevalence of 8.6% in hospital-based HBV cases and 3.3% in healthy donors. The aim of this study was to investigate the prevalence and molecular characterization of HDV in chronic hepatitis B (CHB) patients at the King Abdulaziz University Hospital in Jeddah, Saudi Arabia by molecular and serological techniques. To the best of our knowledge, this is the first study to detect HDV at the molecular level in Saudi Arabia. Patients and Methods: The study included samples from 182 CHB patients from Jeddah; 13 samples with HBsAg negative were excluded. Samples were tested for HDV-Ab, viral RNA by reverse transcriptase–polymerase chain reaction (RT-PCR) in the HDV L-Ag region and sequence analysis. Results: The mean age of the participants was 44.36 years; 75.1% of the participants were Saudi nationals, 58% were males. Nine samples were positive for HDV-Ab and four were borderline; all were subjected to RT-PCR amplification. Three of the positive HDV-Ab cases and 1 borderline case were positive by RT-PCR. All the positive cases had HBV genotype D, and the positive RT-PCR cases were positive for HBV DNA. One of the HDV viremic samples was of genotype 1 by sequencing. The prevalence of HDV in the study was 7.7%, which was lower in Saudis (6.3%) than in non-Saudis (11.9%). Conclusion: HDV coinfection does not seem to have an effect on the clinical status of the recruited CHB cases in this study. More studies are needed to investigate the genetic diversity in other areas such as the southern parts of the Kingdom.

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