Epidemiology of Hepatitis Delta Virus infection in HIV-infected individuals in Taiwan

Introduction

HIV-infected individuals are at higher risk for acquiring HDV. We sought to study the prevalence, genotypes, and associated risk factors causing HDV infection in HIV-infected individuals from an area with high prevalence of hepatitis B virus infection.

Materials and methods

A multicenter study of 341 (22.1%) HBsAg+ from 1543 HIV-infected patients was conducted from 2005 through 2011. Blood samples were collected and analyzed for the presence of antibody to HDV and to determine the genotype of HDV.

Results

The overall prevalence of HDV infection among HBsAg+ carriers was 54.8% (187/341). However, the prevalence among different risk group was distinct. The prevalence of HDV was 73.6%, 13.5%, and 9.2% among HIV-infected IDUs, heterosexual, and MSM, respectively. The main circulating HDV subtypes in our study were genotype IV (60.5%), genotype II (27.6%), and genotype I (11.8%). Multivariate logistic regression analysis revealed that the major risk factor associated with HDV infection was injection drug use, following by HCV infection, HBsAg titer >=250 IU/mL, and duration of injection drug use. A significant increase of cumulative seroprevalence of HDV with duration of IDU from 1 to 15 years was observed (OR: 1.20, 95% CI: 1.09-1.32, P<0.01).

Conclusions

Our study demonstrated high prevalence of HDV infection among HIV-infected IDUs. Effective strategies are needed to prevent injection drug use and to educate ongoing IDUs about the avoidance of practices that lead to infection with HIV, HCV, and HDV.