Hepatitis D Virus Infection Should Be Studied in Patients with Hepatitis B Virus Infection


Seyed Moayed Alavian 1 , *

1 Baqiyatallah Research Centre for Gastroenterology and Liver Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran

How to Cite: Alavian S M. Hepatitis D Virus Infection Should Be Studied in Patients with Hepatitis B Virus Infection, Arch Clin Infect Dis. Online ahead of Print ; 14(4):e84260. doi: 10.5812/archcid.84260.


Archives of Clinical Infectious Diseases: 14 (4); e84260
Published Online: August 4, 2019
Article Type: Letter
Received: September 14, 2018
Revised: June 23, 2019
Accepted: June 30, 2019

Dear Editor,

I read with interest the recently published article by Shadmand et al. (1) in your Journal. The authors presented the epidemiology of hepatitis E and D infections among human immune deficiency virus (HIV)-infected and HIV/hepatitis C virus (HCV)-co-infected patients. They concluded that two (2.7%) cases were positive for anti-hepatitis D virus (HDV) total antibody and one (1.4%) case was positive for anti-HDV IgM antibody. I would like to highlight some points about the prevalence of HDV infection in this study population.

Hepatitis delta infection is caused by co-infection of hepatitis B virus (HBV) and HDV or super-infection of HDV in patients with HBV infection. In other words, HDV cannot replicate and infect the hepatocytes in the absence of HBV (2). The authors did not present any data about HBV infection in this high-risk group in their study and they merely calculated the prevalence of HDV infection in the whole study population. Patients with HIV infection are at high risk of HBV and HDV infection acquisition and coinfection with HIV/HBV/HDV increases the risk of liver-related and other complications (3).



  • 1.

    Shadmand E, Baharlou R, Shokouh MR, Mousavi Nasab SD, Ahmadi Vasmehjani A, Sadeghi K, et al. Sero - epidemiology of hepatitis E and D infections among HIV - infected and HIV/HCV - coinfected patients in Jahrom, Southern Iran. Arch Clin Infect Dis. 2018;13(2). e77069. doi: 10.5812/archcid.77069.

  • 2.

    Sharifzadeh G, Namaei MH, Ebrahimzadeh A, Azarkar Z, Fereidouni M, Bijari B, et al. Prevalence of hepatitis D virus infection and associated factors among HBsAg-positive patients in Birjand, Iran, 2012 - 2014. Hepat Mon. 2017;17(5). e42866. doi: 10.5812/hepatmon.42866.

  • 3.

    Aghasadeghi MR, Mohraz M, Bahramali G, Aghakhani A, Banifazl M, Foroughi M, et al. Frequency and genotype of hepatitis D virus infection in patients infected with HIV and those undergoing hemodialysis. Hepat Mon. 2013;13(5). e7481. doi: 10.5812/hepatmon.7481.

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