Skip to main content

Advertisement

SpringerLink
Log in

Hepatitis delta: on soft paws across Germany

  • Clinical and Epidemiological Study
  • Published:
Infection Aims and scope Submit manuscript

Abstract

Introduction

Globally, more than 350 million people are considered to be chronic carriers of the hepatitis B virus (HBV) infection; thereof, 15–20 million of these individuals are thought to be coinfected with hepatitis delta virus (HDV). The clinical course depends on the mode of transmission; whereas coinfection commonly resolves, superinfection aggravates the disease and progresses to chronicity in over 90 % of the cases, which, again, results in cirrhosis.

Objective

Although many tests are performed in HBV carriers, data on the prevalence of anti-HDV-IgG in Germany are only rarely available and outdated. Therefore, we retrospectively evaluated the seroprevalence of anti-HDV-IgG from the results of our routine service.

Materials and methods

Between January 2000 and October 2011, serum samples from 2,844 patients (carrying hepatitis B surface antigen) admitted to University Hospital Frankfurt am Main, Frankfurt, Germany, were tested for anti-HDV-IgG by enzyme-linked immunosorbent assay (ELISA).

Results

The overall seroprevalence of anti-HDV-IgG in the collective of Frankfurt (n = 2,844) is 7.4 % [95 % confidence interval (CI): 6.4–8.4]. The amount of seropositive men (8.3 %, 95 % CI: 6.9–10) significantly exceeds the female proportion (5.7 %, 95 % CI: 4.3–7.5). The rate of seropositivity to anti-HDV-IgG in this collective of Frankfurt reached a maximum in the year 2003 (10.1 %, 95 % CI: 8.9–11.1). The lowest rate was observable in 2004, where 5.4 % were positive to anti-HDV-IgG.

Conclusion

Of the HBV carriers in Germany, 5–8 % reveal serologic evidence of coinfection with HDV. The vaccination against HBV is the key to prevent HDV infection; therefore, vaccination must strongly be propagated further on.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Rizzetto M, Canese MG, Aricò S, Crivelli O, Trepo C, Bonino F, Verme G. Immunofluorescence detection of new antigen-antibody system (delta/anti-delta) associated to hepatitis B virus in liver and in serum of HBsAg carriers. Gut. 1977;18:997–1003.

    Article  PubMed  CAS  Google Scholar 

  2. Rizzetto M, Hoyer B, Canese MG, Shih JW, Purcell RH, Gerin JL. Delta agent: association of delta antigen with hepatitis B surface antigen and RNA in serum of delta-infected chimpanzees. Proc Natl Acad Sci USA. 1980;77:6124–8.

    Article  PubMed  CAS  Google Scholar 

  3. Rizzetto M. Hepatitis D: thirty years after. J Hepatol. 2009;50:1043–50.

    Article  PubMed  CAS  Google Scholar 

  4. Rizzetto M. Hepatitis D: clinical features and therapy. Dig Dis. 2010;28:139–43.

    Article  PubMed  Google Scholar 

  5. Hughes SA, Wedemeyer H, Harrison PM. Hepatitis delta virus. Lancet. 2011;378:73–85.

    Article  PubMed  Google Scholar 

  6. Farci P. Delta hepatitis: an update. J Hepatol. 2003;39:S212–9.

    Article  PubMed  CAS  Google Scholar 

  7. Hadziyannis SJ. Review: hepatitis delta. J Gastroenterol Hepatol. 1997;12:289–98.

    Article  PubMed  CAS  Google Scholar 

  8. Rizzetto M, Ponzetto A, Forzani I. Hepatitis delta virus as a global health problem. Vaccine. 1990;8:S10–4.

    Article  PubMed  Google Scholar 

  9. Wedemeyer H, Heidrich B, Manns MP. Hepatitis D virus infection—not a vanishing disease in Europe! Hepatology. 2007;45:1331–2.

    Article  PubMed  Google Scholar 

  10. Thierfelder W, Hellenbrand W, Meisel H, Schreier E, Dortschy R. Prevalence of markers for hepatitis A, B and C in the German population. Results of the German National Health Interview and Examination Survey 1998. Eur J Epidemiol. 2001;17:429–35.

    Article  PubMed  CAS  Google Scholar 

  11. Epidemiologisches Bulletin Nr. 29. Berlin: Robert Koch-Instit; 2011.

  12. Wu JC, Chen CM, Sheen IJ, Lee SD, Tzeng HM, Choo KB. Evidence of transmission of hepatitis D virus to spouses from sequence analysis of the viral genome. Hepatology. 1995;22:1656–60.

    PubMed  CAS  Google Scholar 

  13. Rizzetto M. Hepatitis D: clinical features and therapy. Dig Dis. 2010;28:139–43.

    Article  PubMed  Google Scholar 

  14. Wedemeyer H, Yurdaydìn C, Dalekos GN, Erhardt A, Çakaloğlu Y, Değertekin H, Gürel S, Zeuzem S, Zachou K, Bozkaya H, Koch A, Bock T, Dienes HP, Manns MP; HIDIT Study Group. Peginterferon plus adefovir versus either drug alone for hepatitis delta. N Engl J Med. 2011;364:322–31.

    Article  PubMed  CAS  Google Scholar 

  15. Reinheimer C, Allwinn R, Doerr HW. Limited prevalence of influenza A/H1N1v antibodies: footprints of the pandemic of 2010. Infection. 2011;39:101–4.

    Article  PubMed  CAS  Google Scholar 

  16. Sakugawa H, Nakasone H, Nakayoshi T, Kawakami Y, Yamashiro T, Maeshiro T, Kinjo F, Saito A, Zukeran H. Hepatitis B virus concentrations in serum determined by sensitive quantitative assays in patients with established chronic hepatitis delta virus infection. J Med Virol. 2001;65:478–84.

    Article  PubMed  CAS  Google Scholar 

  17. Yamashiro T, Nagayama K, Enomoto N, Watanabe H, Miyagi T, Nakasone H, Sakugawa H, Watanabe M. Quantitation of the level of hepatitis delta virus RNA in serum, by real-time polymerase chain reaction—and its possible correlation with the clinical stage of liver disease. J Infect Dis. 2004;189:1151–7.

    Article  PubMed  CAS  Google Scholar 

  18. Hadziyannis SJ, Sherman M, Lieberman HM, Shafritz DA. Liver disease activity and hepatitis B virus replication in chronic delta antigen-positive hepatitis B virus carriers. Hepatology. 1985;5:544–7.

    Article  PubMed  CAS  Google Scholar 

  19. Mumtaz K, Ahmed US, Memon S, Khawaja A, Usmani MT, Moatter T, Hamid S, Jafri W. Virological and clinical characteristics of hepatitis delta virus in South Asia. Virol J. 2011;8:312.

    Article  PubMed  Google Scholar 

  20. Fattovich G, Boscaro S, Noventa F, Pornaro E, Stenico D, Alberti A, Ruol A, Realdi G. Influence of hepatitis delta virus infection on progression to cirrhosis in chronic hepatitis type B. J Infect Dis. 1987;155:931–5.

    Article  PubMed  CAS  Google Scholar 

  21. Weber B, Rabenau H, Berger A, Scheuermann EH, Staszewski S, Kreuz W, Scharrer I, Schoeppe W, Doerr HW. Seroprevalence of HCV, HAV, HBV, HDV, HCMV and HIV in high risk groups/Frankfurt a.M., Germany. Zentralbl Bakteriol. 1995;282:102–12.

    Article  PubMed  CAS  Google Scholar 

  22. Zaki H, Darmstadt GL, Baten A, Ahsan CR, Saha SK. Seroepidemiology of hepatitis B and delta virus infections in Bangladesh. J Trop Pediatr. 2003;49:371–4.

    Article  PubMed  Google Scholar 

  23. Viana S, Paraná R, Moreira RC, Compri AP, Macedo V. High prevalence of hepatitis B virus and hepatitis D virus in the western Brazilian Amazon. Am J Trop Med Hyg. 2005;73:808–14.

    PubMed  Google Scholar 

  24. Erhardt A, Hoernke M, Heinzel-Pleines U, Sagir A, Göbel T, Häussinger D. Retrospective analysis of chronic hepatitis D in a West German University clinic over two decades: migratory pattern, prevalence and clinical outcome. Z Gastroenterol. 2010;48:813–7.

    Article  PubMed  CAS  Google Scholar 

  25. Langer BC, Frösner GG, von Brunn A. Epidemiological study of viral hepatitis types A, B, C, D and E among Inuits in West Greenland. J Viral Hepat. 1997;4:339–49.

    Article  PubMed  CAS  Google Scholar 

  26. Mohammad Alizadeh AH, Ranjbar M, Tehrani AS, Keramat F, Mamani M, Rezazadeh M, Aini P, Khalilian A, Majlesi A, Hajilooi M. Seroprevalence of hepatitis D virus and its risk factors in the west of Iran. J Microbiol Immunol Infect. 2010;43:519–23.

    Article  PubMed  Google Scholar 

  27. Kim HS, Kim SJ, Park HW, Shin WG, Kim KH, Lee JH, Kim HY, Jang MK. Prevalence and clinical significance of hepatitis D virus co-infection in patients with chronic hepatitis B in Korea. J Med Virol. 2011;83:1172–7.

    Article  PubMed  Google Scholar 

  28. Inoue J, Takahashi M, Nishizawa T, Narantuya L, Sakuma M, Kagawa Y, Shimosegawa T, Okamoto H. High prevalence of hepatitis delta virus infection detectable by enzyme immunoassay among apparently healthy individuals in Mongolia. J Med Virol. 2005;76:333–40.

    Article  PubMed  CAS  Google Scholar 

  29. Shaikh MA, Shaikh WM, Solangi GA, Shaikh BA, Soomro MA. Frequency of hepatitis D virus infection in hepatitis B surface antigen-positive liver diseases. J Coll Physicians Surg Pak. 2011;21:23–5.

    PubMed  Google Scholar 

  30. Roingeard P, Sankalé JL, Dubois F, Diouf A, Bacha A, Mboup S, Goudeau A. Infection due to hepatitis delta virus in Africa: report from Senegal and review. Clin Infect Dis. 1992;14:510–4.

    Article  PubMed  CAS  Google Scholar 

  31. Genné D, Rossi I. Hepatitis delta in Switzerland: a silent epidemic. Swiss Med Wkly. 2011;141:w13176.

    PubMed  Google Scholar 

  32. Cross TJ, Rizzi P, Horner M, Jolly A, Hussain MJ, Smith HM, Vergani D, Harrison PM. The increasing prevalence of hepatitis delta virus (HDV) infection in South London. J Med Virol. 2008;80:277–82.

    Article  PubMed  Google Scholar 

  33. Yurdaydın C, Idilman R, Bozkaya H, Bozdayi AM. Natural history and treatment of chronic delta hepatitis. J Viral Hepat. 2010;17:749–56.

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Institute of Medical Virology, Hospital of the Johann Wolfgang Goethe University, 60596, Frankfurt am Main, Germany

    C. Reinheimer, H. W. Doerr & A. Berger

Authors
  1. C. Reinheimer
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. H. W. Doerr
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A. Berger
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to C. Reinheimer.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Reinheimer, C., Doerr, H.W. & Berger, A. Hepatitis delta: on soft paws across Germany. Infection 40, 621–625 (2012). https://doi.org/10.1007/s15010-012-0287-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s15010-012-0287-9

Keywords

Search

Navigation