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High prevalence of Dual or Triple Infection of Hepatitis B,
C and Delta Viruses among Patients with Chronic Liver Disease
in Mongolia
Mongolia is known for its high endemicity for hepatitis
B virus (HBV), hepatitis
C virus (HCV), and hepatitis delta virus (HDV)
infections among apparently healthy individuals. However,
there are little or no data on the prevalence and genotype
distribution of HBV, HCV, and HDV among patients with chronic
liver disease in Mongolia.
Therefore,
serum samples obtained in 2004 from 207 patients including
those with chronic hepatitis (n = 90), liver cirrhosis (n
= 41), and hepatocellular carcinoma (n = 76) were tested for
serological and molecular markers of HBV, HCV, and HDV infections.
Results
Of
the 207 patients, 144 (69.6%), 106 (51.2%), and 117 (56.5%)
tested positive for hepatitis B surface
antigen (HBsAg) and/or HBV DNA,
HCV
RNA, and HDV RNA, respectively.
Collectively,
172 patients (83.1%) were viremic for one or more of these
viruses, including dual viremia of HBV/HDV (26.6%) or HBV/HCV
(7.7%) and triple HBV/HCV/HDV viremia (30.0%).
Of
note, triple ongoing infection was significantly more frequent
among patients with hepatocellular carcinoma than among those
with chronic hepatitis (63.2% vs. 14.4%, P < 0.0001).
One
hundred sixty patients (77.3%) had a history of blood transfusion
and/or surgery.
The
distribution of HBV
genotypes among the 116 HBV-viremic patients
was: A (0.9%), B (0.9%), C (6.0%), D (88.8%), and C plus D
(3.4%).
All
117 HDV isolates were classified into genotype I.
The
106 HCV RNA-positive samples were typed as genotype
1b (92.5%), 2a
(0.9%), or 1b
plus 2a (6.6%);
Mixed
infection of two distinct HCV genotypes was found exclusively
in the patients with hepatocellular
carcinoma.
Division of Virology, Department of Infection and Immunity,
Jichi Medical
School, Tochigi-Ken, Japan.
10/31/05
Reference
B Tsatsralt-Od. High prevalence of dual or triple infection
of hepatitis B, C, and delta viruses among patients with chronic
liver disease in Mongolia.
Medical
Virology 77(4):491-499.
October 27, 2005 [Epub ahead of print].
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