Impact of hepatitis B and delta virus co-infection on liver disease in Mauritania: A cross sectional study - 28/09/13

Doi : 10.1016/j.jinf.2013.06.008

Françoise Lunel-Fabiani ^a,^b,^⁎,^{^{h
Authors contributing equally to this work.}} , Wael Mansour ^a,^b,^d,^e,^{^{h
Authors contributing equally to this work.}}, Abdellahi Ould Amar ^c, Mohamed Aye ^c, Frédéric Le Gal ^d,^e, F- Zahra Fall Malick ^f, Lô Baïdy ^f, Ségolène Brichler ^d,^e, Pascal Veillon ^a,^b, Alexandra Ducancelle ^a,^b, Emmanuel Gordien ^d,^e,^{^{h
Authors contributing equally to this work.}}, Michel Rosenheim ^g,^{^{h
Authors contributing equally to this work.}}
^a Laboratoire de virologie, CHU Angers, France
^b Laboratoire HIFIH, UPRES EA3859 Faculté de Médecine d'Angers, France
^c Hepato-gastroenterology Department, National Hospital, Nouakchott, Mauritania
^d Service de Bactériologie, Virologie – Hygiène, Assistance Publique –Hôpitaux de Paris, Hôpitaux universitaires de Paris Seine Saint-Denis, Site Avicenne, Bobigny, France
^e Laboratoire associé au Centre National de Référence des Hépatites B, C et Delta, Université Paris Nord, Sorbonne Paris Cité, France
^f National Public Health Institute, Nouakchott, Mauritania
^g Université Pierre et Marie Curie, Paris, France et service de Santé Publique, Groupe Hospitalier Pitié-Salpêtrière, Paris, France

^∗Corresponding author. Laboratoire de virologie, Département de biologie des agents infectieux et pharmaco-toxicologie, Institut de Biologie en Santé CHU d'Angers, 4, rue Larrey, 49933 Angers Cedex 9, France. Tel.: +33 2 41 35 47 09; fax: +33 2 41 35 41 64.

Summary

Objectives

Mauritania is a highly endemic region for hepatitis B (HBV) and delta (HDV) viruses. No data are available on HDV's impact on the severity of liver disease in consecutive HBV-infected patients in Africa. This study evaluated the degree of liver fibrosis in a cohort of chronic HBV carriers.

Methods

Three-hundred consecutive HBV-infected Mauritanian patients were checked for HDV infection via the detection of anti-HDV antibodies (Ab) and viral RNA. HBV- vs. HBV/HDV-infected patients were compared by physical examination, biological analyses, and the APRI (aspartate aminotransferase to platelet ratio index) and FibroMeter tests for determination of liver fibrosis.

Results

More than 30% of the patients had anti-HDVAb. Among these, 62.2% were HDV-RNA positive. Co-infected patients were older (>8-years) than HBV-mono-infected patients. They had more liver tests abnormalities and clinical or ultrasound signs of liver fibrosis. APRI and FibroMeter scores were also significantly increased in these patients. In multivariate analysis, beyond HDVAb, male gender and HBV-VL >3.7 log IU/mL were the only markers linked to significant liver fibrosis.

Conclusions

In Mauritania, HDV co-infection worsens liver disease, both clinically and biologically, as confirmed by the APRI and FibroMeter tests. These tests may be useful for the management of delta hepatitis, which is a major health problem in Mauritania.

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Keywords : HBV, HDV, Mauritania, FibroMeter, APRI, Liver fibrosis, Cirrhosis

Plan

Assessment of liver fibrosis

Demographic and epidemiological data

Clinical features

HBV and HDV molecular analyses

Liver fibrosis and cirrhosis

Discussion

Financial support

Potential conflict of interest

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Vol 67 - N° 5

P. 448-457 - novembre 2013 Retour au numéro

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Impact of hepatitis B and delta virus co-infection on liver disease in Mauritania: A cross sectional study - 28/09/13

Summary

Objectives

Methods

Results

Conclusions

Plan

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