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Abstract
Objectives Hepatitis delta virus (HDV) is the smallest human virus that causes the most severe form of viral hepatitis. However, the virus’s biological features, transmission routes and causes of endemicity in particular populations are not yet fully understood. HDV shares the hepatitis B virus (HBV) parenteral mode of transmission with HBV; therefore, sexual transmissions are also possible. However, data on sexual transmission of HDV are limited.
Methods This study included 60 patients with chronic HBV/HDV coinfection. The median age (IQR) of patients was 35 (23–47) years, and all were Mongolian. HDV-RNA, HBV-DNA and hepatitis B surface antigens were tested in serum, seminal plasma and cervical swab samples collected at the Liver Centre, Mongolia. Binary logistic regression analysis was used to create a model that predicts the possibility of HDV detection in seminal plasma and cervical swab samples based on HDV-RNA levels in serum samples.
Results HDV-RNA was detected in cervical swab samples from 24 of 30 patients (80%) and in seminal plasma from 15 of 30 patients (50%) (Fisher’s exact test, p=0.03). Patients with detectable HDV-RNA in either seminal or cervical fluid samples showed higher levels of HDV-RNA in serum ((females: 6.44 vs 4.21 log IU/mL (p<0.0001); males: 6.69 vs 5.65 log IU/mL (p<0.0001)). A correlation between HDV-RNA levels in the serum was identified in females (r=0.56, p=0.004; 95% CI 0.206 to 0.788) but not in males (r=0.38, p=0.15, 95% CI −0.15 to 0.75). The regression model identified threshold points of serum HDV-RNA levels that can be used to predict HDV-RNA detection in seminal plasma and cervical swabs.
Conclusions HDV-RNA can be detected in cervical swabs and seminal plasma of patients with HBV/HDV coinfection, and the detection was more common in females than in males. The probability of HDV-RNA detection in male seminal plasma and female cervical swab samples can be predicted based on the HDV viral load in serum.
- Hepatitis D
- VIROLOGY
- INFECTION
- HEPATITIS
Data availability statement
Data are available upon reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information. Not applicable. Data are provided as supplementary information.
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Data availability statement
Data are available upon reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information. Not applicable. Data are provided as supplementary information.
Footnotes
Contributors SE: Conceived and developed the methodology, collected data and samples, performed statistical analysis and wrote and revised the manuscript. OL-O: Contributed to sample and data collection and methodology development. AP: Contributed to sample collection. GA: Contributed and performed statistical analysis. MPA: Contributed to manuscript writing. AE: Conceived the study idea and contributed to the study design. NA, OR and NV: Contributed to sample collection. ME: Contributed to methodology development. ND: Contributed to manuscript revision and critical review. OO: Conceived the study design, methodology development, performed statistical analysis and wrote and revised the manuscript. All authors read and approved the final manuscript and agree to be accountable for all aspects of the work in ensuring that any questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. As well, SE has submitted the manuscript. OR is responsible for the overall content as the guarantor. Manuscript edited by Paperpal, which included checking for grammar and punctuation errors.
Funding This study was partially funded by the Mongolian Foundation for Science and Technology. In addition, this research received funding from the National University of Mongolia under agreement P2021-1234.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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