Hepatitis delta virus and GBV-C infection in two neighboring hepatitis B virus and hepatitis C virus-endemic villages in Taiwan.

BACKGROUND Previous reports in Taiwan have shown that the hepatitis B virus (HBV)- and hepatitis C virus (HCV)-endemic areas are also endemic for hepatitis D virus (HDV), GBV-C and TT virus. This study aimed to elucidate the epidemiology of HDV and GBV-C infection in two neighboring HBV- and HCV-endemic villages, to deduce the epidemiological characteristics of multiple viral infections in communities. METHODS A total of 74 adult residents of Wukwai (W) village and 95 adults residents of Haipu (H) village were studied. Laboratory tests for all subjects included alanine transaminase (ALT), hepatitis B surface antigen (HBsAg), anti-HCV, HCV RNA, genotype of HCV, GBV-C RNA, and anti-GBV-C E2. Anti- HDV was checked only in HBsAg-positive subjects. RESULTS Subjects from W village were older than those from H village (61.7 +/- 11.8 vs 56.6 +/- 16.4 years, p = 0.02). The prevalence of ALT elevation (37.8% vs 15.8%, p = 0.006), anti-HCV (67.6% vs 34.7%, p < 0.0001), and GBV-C infection (39.2% vs 24.2%, p = 0.054), and the distribution of HCV genotype 1b (37.8% vs 70.4%, p = 0.01) were different in W and H villages, respectively. Among anti-HCV-positive subjects, HCV RNA-positive rates were 75.9% (63/83), and were higher for men (88.2%) than women (67.3%). Only one HBsAg-positive subject was positive for anti-HDV, and one anti-HCVnegative subject was positive for HCV RNA. In multivariate analyses, GBVC infection correlated with HCV infection or HCV endemicity, and HCV RNA was the only determining factor in ALT elevation. CONCLUSION In HBV and HCV-endemic areas, GBV-C was more prevalent in areas with a higher prevalence of anti-HCV. Positive HCV-RNA, but not GBV-C infection, was associated with ALT elevation.