Molecular characterization of hepatitis delta virus strains isolated from patients at the Institut Pasteur de Bangui, Central African Republic, 2014 - 2017

BackgroundHepatitis delta virus (HDV) can establish a persistent infection in people with chronic hepatitis B, leading to the accelerated progression of liver disease. Our study aimed to establish the prevalence of HDV and update the molecular characterization of HDV in the population carrying hepatitis B surface antigens (HBsAg) in Bangui, the capital of the Central African Republic.MethodologyWe collected 946 plasma samples from HBsAg-positive patients at the Institut Pasteur de Bangui in the Viral Hepatitis Laboratory from archived samples collected from 2014 to 2017. No information on severe liver disease or treatment history was available. Total anti-HDV antibodies (IgG) were assayed using a commercial enzyme-linked immunosorbent assay (ELISA) kit. Subsequently, the R0 region was amplified by reverse-transcription PCR and sequenced. HDV isolates were genotyped and analyzed statistically.ResultsPrevalence of anti-HDV antibodies (IgG) was 18.18% (172/946). Of the 172 samples positive for anti-HDV antibodies, 111 HDV-positive samples (64.5%) were from males and 61 were from females (35.46%). The highest HDV prevalence (39.5%) was found in patients over 40 years old, and the lowest (1.1%) was found in the 0–10 years age group. The risk of HDV infection was very high in year 2015 (p = 0.009). Nucleotide sequences of HDV-RNA were obtained for 61 HDV-IgG positive samples of which 60 isolates belonged to the HDV-1 clade and 1 belonged to HDV-8.ConclusionA high prevalence of HDV was found in the study population, but was not evenly distributed across age groups. Patients over 40 had the highest prevalence of HDV. The study identified a predominance of the HDV-1 clade, but clade HDV-8 was also detected.