The prevalence of hepatitis delta virus infection in acute and chronic liver diseases in Turkey: an analysis of clinical studies.

BACKGROUND/AIMS: The objective of this study was to review the studies on hepatitis D virus-related liver diseases and to evaluate the national and regional outcomes in order to identify the hepatitis D virus infection in Turkey. METHODS: This retrospective study included 2182 acute viral hepatitis, 6613 inactive HBsAg carriers, 5961 chronic hepatitis B, 1264 liver cirrhosis and 748 hepatocellular carcinoma cases, who were evaluated for anti-hepatitis D virus positivity at several centers in Turkey since 1980's. ELISA method was used and the results were statistically evaluated. RESULTS: The anti-hepatitis D virus positivity was 3.0% in 1416 acute viral hepatitis and 8.1% in 766 acute hepatitis B cases. This ratio was significantly higher in Diyarbakir than in Istanbul and Ankara for acute viral hepatitis (p<0.001). The mean anti-hepatitis D virus was 4.9% in inactive HBsAg carriers and significantly decreased from 1980 to 2005 (4.1% and 2.9%, respectively p<0.001). The anti- hepatitis D virus was 20% in chronic hepatitis B and 32.5% in liver cirrhosis cases. The positivity were significantly lower in Istanbul and Izmir compared to Diyarbakr and Van (p<0.001). Antihepatitis D virus positivity was decreased in all regions for the last two decades (p<0.001). The rates decreased from 31% to 11% for chronic hepatitis B and from 43.3% to 24% for liver cirrhosis (p<0.001). The mean anti-hepatitis D virus was 23% in hepatocellular carcinoma cases, which was significantly lower in Istanbul and Izmir compared to Diyarbakr and Elaz currency (p<0.0001). CONCLUSIONS: The hepatitis D virus infection is a critical problem in our country, particularly in the Eastern and Southeastern Anatolia. In recent years, the hepatitis D virus infection is decreasing countrywise, however the rate still remains to be critical.