Prevalence and associated factors of hepatitis d antibody among hepatitis b-infected adults with decompensated cirrhosis and hepatocellular carcinoma in Kiruddu Hospital

Abstract

Introduction: Chronic viral hepatitis B (HBV) remains a leading cause of death in sub-Saharan Africa. Despite concerted effort to eliminate as a public health threat by 2030, data on its coinfection with Hepatitis D infection (HDV) remains scanty. Coinfection with HBV and HDV is associated with severe liver disease, chronicity of hepatitis B and poor disease outcomes. Objective: The aim of this study was to determine the prevalence and factors associated with hepatitis D antibody in hepatitis B infected patients with decompensated liver cirrhosis and/or hepatocellular carcinoma in a tertiary care institution in Uganda. Methods: This cross-sectional study was conducted on the gastroenterology service of Kiruddu National Referral Hospital. Consecutive patients with HBV-related decompensated cirrhosis and/or hepatocellular carcinoma were recruited. Their socio-demographics, liver disease-related history, risk factors for acquisition of HBV and HDV and physical findings compatible with decompensated liver disease were captured on a data collection tool. A blood sample was drawn and analyzed for anti-HDV using CUSABIO® HDV IgG ELISA assay kit. Data was analyzed using R v4.4.1 software package to determine the prevalence and factors associated with anti-HDV. Results: Out of the 122 that were enrolled, 26 tested positive for anti-HDV, resulting in an anti-HDV prevalence of 21.3%. There was a statistical significance of association of anti-HDV with region of origin. None of the sociodemographic, clinical examination or laboratory factors were associated with anti-HDV positivity. Conclusion and recommendations: Our study has revealed a high prevalence of anti-HDV among HBV infected patients with decompensated liver disease, none of the traditional risk factors were associated with anti-HDV. There is need for routine anti-HDV screening in patients with cirrhosis and/or HCC to guide treatment decisions.