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Introduction <p>Despite Nigeria’s high burden of hepatitis B virus (HBV), the epidemiological landscape of hepatitis D virus (HDV) remains largely unexplored. Consequently, HDV remains under-recognized as a public health concern, slowing down efforts to improve surveillance and clinical care. We investigated HDV infection among distinct HBV-positive populations in Nigeria, including individuals with chronic HBV infection living with or without HIV and those with hepatocellular carcinoma (HCC) and/or cirrhosis.</p> Method <p>A cross-sectional study that involved 390 HBV-infected adults recruited from five tertiary-level hospitals in Nigeria. HDV total antibodies (anti-HDV) were determined in 379 samples using an automated chemiluminescent immunoassay. HDV-RNA quantification was performed in all 379 patients. Samples with detectable HDV-RNA were subjected to Sanger sequencing, and results analyzed using bioinformatics tools.</p> Results <p>The overall anti-HDV antibody (HDV-Ab) seroprevalence was 8.1% with a significant difference observed across individual clinical groups: 4.1%, 11.0%, and 15.2% in asymptomatic HBV carriers, HCC/cirrhosis, HIV/HBV co-infection, respectively. Compared with asymptomatic HBV participants, HCC/cirrhosis (adjusted OR 2.71, 95% CI 1.04–7.48) and HIV/HBV (adjusted OR 3.28, 95% CI 1.20–9.25) groups had higher odds of anti-HDV positivity. HDV-RNA was detectable in 22.6% of all anti-HDV positive samples, with viral load ranging from 26.9 IU/mL to 234,000 IU/mL. HDV genotypes 1 and 5 were identified in HDV-RNA detectable samples.</p> Conclusion <p>This study reveals higher anti-HDV rates in HIV/HBV coinfected individuals and suggests HDV as a significant contributor to liver cancer burden in Nigeria. These findings underscore the need for routine HDV screening among high-risk HBV-infected populations to enhance early detection and guide clinical management.</p>

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Hepatitis delta virus co-infection in patients with hepatocellular carcinoma and people living with HIV in Nigeria

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月26日

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  • Ijeoma Ifeorah,
  • Birgit Bremer,
  • Yusuf Musa,
  • Julia Kahlhöfer,
  • Oluwatosin Oguntoye,
  • Carey Tishiya,
  • Gatuwa Aglavdawa,
  • Ojonuga Ameh,
  • Yussuf Abdulkadir,
  • Olumuyiwa Ariyo,
  • Manfred Anim,
  • Andre Reinhardt,
  • Albert Heim,
  • Uwem George,
  • Lukman Abdulkareem,
  • Ibrahim Umar Garzali,
  • Heiner Wedemeyer,
  • Lisa Sandmann

摘要

Introduction

Despite Nigeria’s high burden of hepatitis B virus (HBV), the epidemiological landscape of hepatitis D virus (HDV) remains largely unexplored. Consequently, HDV remains under-recognized as a public health concern, slowing down efforts to improve surveillance and clinical care. We investigated HDV infection among distinct HBV-positive populations in Nigeria, including individuals with chronic HBV infection living with or without HIV and those with hepatocellular carcinoma (HCC) and/or cirrhosis.

Method

A cross-sectional study that involved 390 HBV-infected adults recruited from five tertiary-level hospitals in Nigeria. HDV total antibodies (anti-HDV) were determined in 379 samples using an automated chemiluminescent immunoassay. HDV-RNA quantification was performed in all 379 patients. Samples with detectable HDV-RNA were subjected to Sanger sequencing, and results analyzed using bioinformatics tools.

Results

The overall anti-HDV antibody (HDV-Ab) seroprevalence was 8.1% with a significant difference observed across individual clinical groups: 4.1%, 11.0%, and 15.2% in asymptomatic HBV carriers, HCC/cirrhosis, HIV/HBV co-infection, respectively. Compared with asymptomatic HBV participants, HCC/cirrhosis (adjusted OR 2.71, 95% CI 1.04–7.48) and HIV/HBV (adjusted OR 3.28, 95% CI 1.20–9.25) groups had higher odds of anti-HDV positivity. HDV-RNA was detectable in 22.6% of all anti-HDV positive samples, with viral load ranging from 26.9 IU/mL to 234,000 IU/mL. HDV genotypes 1 and 5 were identified in HDV-RNA detectable samples.

Conclusion

This study reveals higher anti-HDV rates in HIV/HBV coinfected individuals and suggests HDV as a significant contributor to liver cancer burden in Nigeria. These findings underscore the need for routine HDV screening among high-risk HBV-infected populations to enhance early detection and guide clinical management.