Molecular Epidemiology And Influencing Factors Of Hepatitis D Virus In Yunnan Province

Objectives:Hepatitis D virus(HDV)is a single-stranded circular RNA virus,a satellite virus of hepatitis B virus(HBV),and is the smallest RNA virus known to infect humans.Although HDV is a defective virus,its co-infection with hepatitis B virus will rapidly accelerate the course of liver cirrhosis and increase the risk of liver cancer,resulting in the world’s most serious hepatitis disease,greatly endangering human health and people’s lives and property.Although the virus has been identified more than 40 years ago,little attention has been paid to the hepatitis D virus by the scientific community and the public.Nearly 10 million people in China are infected with HDV,but they have not paid attention to it due to the lack of sufficient epidemiological data.As a high-incidence area of HBV infection in China,Yunnan is faced with a great risk of HDV transmission epidemic due to the prevalence of drugs,sex trafficking and HIV,and the epidemiological study of HDV in Yunnan is very important for the overall prevention and control of HDV in China.This study aims to elucidate the epidemiological characteristics of HDV in Yunnan Province,the associated risk factors affecting HDV infection,and the clinical features.Methods:1790 plasma samples from the First People’s Hospital of Yunnan Province,Chenggong Hospital of Yan’an Hospital affiliated to Kunming Medical University,the First People’s Hospital of Zhaotong City and the First People’s Hospital of Qujing City that tested positive for hepatitis B virus.Collect patient demographics,clinical biochemical test results,and laboratory test data.All plasma samples were tested for anti-HDV Ig G,anti-HDV Ig M,antibodies by using ELISA kits and HDV RNA by conventional PCR.Univariate and multivariate logistic regression models were used to analyze the risk factors associated with HDV in HBV-infected patients.Results:In 1790 plasma samples that tested positive for hepatitis B virus,the overall serum anti-HDV positivity rate was 125 patients(6.98%),Anti-HDV Ig G antibody positive in103 patients(5.75 %),Anti-HDV Ig M antibody positive in 22 patients(1.23 %),0samples tested positive for both anti-HDV Ig G antibody and anti-HDV Ig M antibody.All samples tested negative for HDV RNA.We found that Alanine aminotransferase levels Lactate dehydrogenase levels,HBV surface antigen level,HBV E antigen level,HBV E antibody level,HBV core antibody level were associated with HDV infection.Although hepatitis B virus E antibody and hepatitis B virus core antibody are influencing factors of anti-HDV antibody positivity,they are not valuable for diagnosing anti-HDV antibody positivity.Conclusions:The HBV infection rate in Yunnan Province who tested positive for hepatitis B virus was high,Nearing global rates of HDV infection among HBV carriers.Ethnicity,education level,and alkaline phosphatase level are relevant risk factors for HDV coinfection in hepatitis B virus carriers.Further research is needed regarding the predominant circulating strains and genotypes of HDV in this population,as well as the clinical features of HDV co-infection in hepatitis B virus carriers.Vertical mother-tochild transmission of HDV does exist,and the risk of mother-to-child transmission of HBV/HDV is substantially reduced due to passive-active immunization of newborns,but remains.