HEPATITIS-B, HEPATITIS-C, AND HEPATITIS-D VIRUS-INFECTIONS IN PATIENTS WITH CHRONIC HEPATITIS, CIRRHOSIS, AND HEPATOCELLULAR-CARCINOMA - A COMPARATIVE-STUDY IN NIGER

Eighty-nine Sahelian African patients with chronic active hepatitis (C AH) (14), cirrhosis (49), hepatocellular carcinoma (HCC) (26), and 47 controls were tested for hepatitis B virus (HBV, hepatitis B surface a ntigen [HBsAg]) and hepatitis D virus (HDV, anti-HDV antibody). Sevent y-three percent of the patients were positive for HBsAg versus 29.8% o f the controls (P < 0.0001). With anti-HDV test, 55.0% of the patients were positive versus 17.0% of the controls (P < 0.0001). To assess th e prevalence of antibody to hepatitis C virus (HCV), we used an enzyme -linked immunosorbent assay for screening (anti-HCV2): 19.1% of the pa tients were positive versus 6.4% of the controls (P < 0.05). An associ ation between HBsAg and anti-HDV-positive test results was found in 46 .1% of the patients versus 6.4% of the controls (P < 0.0001). A combin ation of HBsAg and anti-HCV2-positive test results was found in 13.5% of the patients versus 2.2% of the controls (P < 0.05). Anti-HDV and a nti-HCV2 test results were positive in 13.5% of the patients versus 2. 2% of the controls (P < 0.05). Triple-positive test results (HBsAg, an ti-HDV, and anti-HCV2) were found in 11.2% of the patients but in none of the controls (P < 0.025). Triple negative test results were found in 14.6% of the patients versus 57.4% of the controls (P < 0.0001). Th e predominant association of the chronic HBV infection with CAH, cirrh osis, and HCC is confirmed in Sahelian Africa. The HDV superinfection (chronic HBV plus HDV infections) may be a major etiology. The HCV inf ection is less common but the association of HDV and HCV infections is present.