Massimo De Paschale, Maria Teresa Manco, Luisa Belvisi, Carlo Magnani, Tiziana Re, Paolo Viganò, Francesca Capelli, Antonino Mazzone, Maria Pia Baldacci, Anna Lisa Neri, Carlo Maria Guastoni, Giovanna Lunghi, Pierangelo Clerici
Objective: The presence of anti-HDV antibodies in HBsAg-positive subjects suggests HBV/HDV co-infection. Anti-HDV antibodies may remain after recovery and the disappearance of HBsAg, but active HDV and/or HCV infections can also sometimes decrease HBsAg production. However, there are few epidemiological data concerning anti-HDV antibodies in HBsAg-negative subjects. The aims of this study were to determine the prevalence of anti- HDV antibodies in HBsAg-negative subjects with other markers of HBV infection in an urban area of northern Italy in order to evaluate their significance in the presence/absence of HCV, and to contribute to HDV epidemiology by comparing the results with those obtained in a previous study of HBsAg-positive subjects in the same area.
Methods: Anti-HDV antibodies were retrospectively investigated in 1287 HBsAg-negative/anti-HBc-positive subjects who hade been examined for HBV markers. Signs of possible liver alterations and HCV and HIV infections were sought in the clinical records of the anti-HDV-positive patients, and HBV-DNA, anti-HBc IgM, anti-HDV IgM and HDV-RNA were detected.
Results: Thirteen samples (1.0%) were anti-HDV-positive. The clinical evaluation of 12 of these patients showed that nine had had previous HBV/HDV co-infections; two had concomitant HCV infection, and one occult HBV infection. The prevalence of past HDV infection was 0.7%. The prevalence of anti-HDV in HBsAgpositive patients in the same area was 4.9%.
Conclusion: The prevalence of past HDV infection in the study area is low, but interference from HCV is possible in a few cases. Comparison with data obtained from HBsAg-positive subjects suggests that about one-quarter of HBV/HDV co-infections resolve naturally.
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