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Clinical Features and Seroepidemiology of Anti-HDV Antibody in patients With Chronic Hepatitis B Virus Infection in Iran: A Meta-Analysis


neda Amini 1 , Seyed Moayed Alavian 2 , * , Ali Kabir 1 , Seyed Yaser Saiedi Hosseini 1 , Seyed Hossein Aalaei-Andabili 1


1 Tehran University of Medical Sciences, Students Scientific Research Center, IR Iran

2 Baqiyatallah Research Center for Gastroenterology and Liver Diseases, Baqiyatallah University of Medical Sciences, alavian@thc.ir, IR Iran

How to Cite: Amini N, Alavian S, Kabir A, Hosseini S, Aalaei-Andabili S H. Clinical Features and Seroepidemiology of Anti-HDV Antibody in patients With Chronic Hepatitis B Virus Infection in Iran: A Meta-Analysis, Hepat Mon. Online ahead of Print ; 11(12):960-967. doi: 10.5812/kowsar.1735143X.805.


Hepatitis Monthly: 11 (12); 960-967
Article Type: Review Article
Received: October 15, 2011
Accepted: December 29, 2011




Context: Hepatitis delta virus (HDV) leads to the most severe form of chronic viral hepatitis.
Objectives: To determine the prevalence of HDV and create pooled estimations of possible risk factors, a systematic review was conducted to collect all epidemiological studies on HDV among chronic hepatitis B patients in Iran.
Data Sources: In this systematic review, databases such as PubMed, Embase, ISI, Google scholar, and Iranian databases (MagIran, Iranmedex, and SID) were searched.
Study Selection: Studies that clearly stated information about the number of HBsAg positive patients infected with HDV were selected.
Data Extraction: The name of the city, the author's name, year of study, HDV detection method, sample size, HBsAg positive frequency, mean age, total prevalence of HDV, and risk factors were extracted.
Results: The pooled HDV prevalence was 7.8% (95% CI: 5.89 - 9.71). In the survey-data analysis, HDV prevalence was 6.61%. HDV prevalence was 30.47% (95% CI: 9.76 to 51.19), 14.4% (95% CI: 7.72 to 21.07), and 4.94% (95% CI: 3.73 to 6.15) in cirrhotic, chronic-hepatitis, and inactive-carrier patients, respectively. Pooled ORs were calculated for several factors common to Iranian HBsAg-positive patients, including history of blood transfusion [OR: 1.1 (95% CI: 0.40 to 2.98)], intravenous drug abuse [OR: 1.6 (95% CI: 0.78 to 3.21)], previous hemodialysis [OR: 1.72 (95% CI: 0.79 to 3.76)], and HBeAg-positive status [OR: 1.26 (95% CI: 0.66 to 2.4)].
Conclusions: The prevalence of HDV is less common in Iran than in endemic regions such as Italy and Turkey; however, it is a severe form of hepatitis in HBsAg-positive patients. The most probable route of HDV transmission is hematologic, which suggests the importance of blood screening for HDV, especially in groups with numerous blood transfusions.

Implication for health policy/practice/research/medical education:
This article is a collection of epidemiological studies on HDV in chronic hepatitis B patients in Iran. Study of the present article is highly recommended to hepatologists, gastroenterologists, virologists and epidemiologists.

Please cite this paper as:
Amini n, Alavian SM, Kabir A, Saiedi Hosseini SY, Aalaei-Andabili SH. Clinical Features and Seroepidemiology of Anti-HDV Antibody in patients With Chronic Hepatitis B Virus Infection in Iran: A Meta-Analysis. Hepat Mon. 2011; 11(12): 960-7. DoI: 10.5812/kowsar.1735143X.805


Hepatitis D Review Meta-Analysis Iran Revalence Epidemiology

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