KOWSAR Hepat Mon. 2011;11(4):269-272 Journal home page: www.HepatMon.ir Hepatitis D virus infection in Isfahan, central Iran: Prevalence and risk fac- tors among chronic HBV infection cases Behrooz Ataei 1, Mohammad Reza Yazdani 1, Hamid Kalantari 2, Majid Yaran 1, Zary Nokhodian 1, Abbas Ali Javadi 1, Anahita Babak 3, Peyman Adibi 2 * 1 Isfahan Infectious Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, IR Iran 2 Isfahan Liver Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, IR Iran 3 Community and Preventive Medicine Specialist, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, IR Iran A R T I C L E I N F O Article Type: Original Article Article history: Received: 04 Mar 2010 Revised: 04 Jun 2010 Accepted: 20 Dec 2010 Keywords: Hepatitis B infection Hepatitis D infection Prevalence Iran A B S T R A C T Background: Hepatitis D virus (HDV) is dependent on hepatitis B virus (HBV) infection. Acute infection with HDV can occur simultaneously with acute HBV infection or be superimposed onto a chronic HBV infection. Objectives: This study aimed to identify cases of HDV and determine its prevalence in patients with chronic HBV infection for the first time study in Isfahan, central Iran. Patients and Methods: In a cross-sectional study in 2009, 346 who had been diagnosed for at least 6 months with chronic HBV were enrolled consecutively. Anti-HDV was measured by ELISA in the serum of these patients. Results: The study included 245 males (70.8%) and 101 (29.2%) females with a mean age of 39 ± 12.4 years. Anti-HDV was present in 8 (3.5%) HBe antibody-positive patients (p = 0.36) and in 2 (2.3%) HBe antigen-positive cases (p = 0.68). No association was found between hepatitis D and probable risk factors. Conclusions: This study demonstrates that the prevalence of HDV infection is higher in patients who are positive for HBeAb compared those who are HBeAg-positive. There- fore, most HDV antibody-positive cases in Isfahan are HBV/HDV superinfections but not coinfections. c 2011 Kowsar M.P.Co. All rights reserved. Implication for health policy/practice/research/medical education: Chronic HDV aggregates chronic hepatitis B infection in the patients. This original paper about super and co-infection of HDV is recommended for medical practitioners and specialists in the field of infection diseases and hepatologists as well as health policy makers. Please cite this paper as: Ataei B, Yazdani MR, Kalantari H, Yaran M, Nokhodian Z, Javadi AA, et al. Hepatitis D virus infection in Isfahan, central Iran: Prevalence and risk factors among chronic HBV infection cases. Hepat Mon. 2011;11(4):269-272. Background Hepatitis B (HBV) is one of the most common public health problems worldwide, especially in developing countries, causing 1 million deaths per year (1). According * Corresponding author at: Peyman Adibi, Isfahan Liver Diseases Re- search Center, Isfahan University of Medical Sciences , Isfahan , IR Iran. Tel: +98-3117923060, Fax: +98-3116687898. E-mail: adibi@med.mui.ac.ir c 2011 Kowsar M.P.Co. All rights reserved. to available estimates, 1.2% to 9.7% of the world’s popula- tion and approximately 2.14% of the Iranian population have an HBV infection (2). Such patients not only are a source of infection but also are susceptible to late com- plications of this virus, such as chronic active hepatitis, cirrhosis, and liver cancer (3). Hepatitis D virus (HDV) is a defective RNA virus that de- pends on the hepatitis B surface antigen (HBsAg) of hepa- titis B virus for its replication, developing exclusively in patients with acute or chronic hepatitis B. Simultaneous