Low sero-prevalence of hepatitis delta antibodies in HIV/ hepatitis  B co-infected patients attending an urban HIV clinic in Uganda.

Elizabeth Katwesigye¹, Emmanuel Seremba², Fred Semitala¹, Ponsiano Ocama
1. Department of Medicine, Mulago Hospital and Makerere University College of
Health Sciences, Kampala, Uganda
2. Department of Medicine, Mulago Hospital, Kampala, Uganda

Abstract
Background: Co-infection with hepatitis B (HBV) and hepatitis D (HDV) is common among human immunodeficiency virus  (HIV) infected individuals in developing countries and it aggressively accelerates progression of liver disease to cirrhosis and  other complications. There is scarcity of data on HDV in sub-Saharan Africa .We investigated the sero-prevalence and factors  associated with HDV antibody among HIV/HBV co-infected patients attending a large urban HIV clinic in Uganda.

Methods: We screened 189 HIV/HBV co-infected individuals for anti-HDV immunoglobulin G (IgG) and performed logistic regression to determine the associated factors. Socio-demographic, clinical data, immunological status, and liver fibrosis (as determined by the Aspartate transaminase to platelet ratio index and transient elastography) were included.

Results: Participants were predominately young and of sound immunologic status (median age 40 years, median CD4 440 cells/µl). 98% were on ART regimens containing anti-HBV active medications (95.2% were on TDF/3TC while 4.8% on 3TC containing regimen). Median duration on ART was 36 months (IQR 22-72). Anti-HDV was detected in 6/198, 3.2% (95% CI 1.14-6.92%), associated with male gender and a duration of more than 5 years since HIV diagnosis.

Conclusions: The sero-prevalence of HDV antibodies among the HIV/HBV co-infected patients is low in a Ugandan urban  cohort.

Keywords:Co-infection in Uganda, hepatitis delta antibodies, hepatitis B virus, HIV.