Objective: To investigate the sero-epidemiological characteristics of the hepatitis D virus (HDV) infection among hepatitis B virus (HBV)-infected patients in Xinjiang region. Methods: A single-center cross-sectional analysis method was used to select 264 cases of hepatitis B virus infection who were hospitalized in the Center for Infectious Diseases and Liver Diseases of the First Affiliated Hospital of Xinjiang Medical University from August 2021 to January 2022. All patients were tested for HDV Ag, HDV IgM, HDV IgG, and HDV RNA. The infection status of hepatitis D virus was analyzed by grouping according to their clinical type, HBV viral load, and HBsAg level. A paired t-test was used for data with measurement data conforming to normal distribution. A paired rank sum test was used for data that did not conform to normal distribution before and after treatment. Results: A total of 36 cases (13.64%) and 26 cases (9.85%) were positive for HDV serological markers and HDV RNA. According to clinical type grouping, the positive rates of HDV serum markers in patients with chronic hepatitis B, hepatitis B-related cirrhosis, liver cancer, and liver failure were 13.46%, 12.43%, and 20.83%, respectively, and there was no statistically significant difference among the three groups (χ2=0.86, P=0.649). The positive rates of HDV RNA were 11.54%, 8.11%, and 20.83%, respectively, and there was no statistically significant difference among the three groups (χ2=4.015, P=0.134). According to HBV viral load grouping, the positive rates of HDV serum markers among patients with viral loads <20, 20-2 000, and >2 000 IU/ml were 17.15%, 7.81%, and 6.67%, respectively, and the difference was not statistically significant among the three groups (χ2=4.846, P=0.089). The positive rates of HDV RNA were 9.47%, 10.94%, and 10%, respectively, and the difference was not statistically significant among the three groups (χ2=0.113, P=0.945). According to HBsAg level grouping, the positive rates of HDV serum markers in HBsAg<0.05, 0.05~250, and >250 IU/ml were 14.29%, 16.67%, and 10.85%, respectively, and there was no statistically significance between the three groups (χ2=1.745, P=0.418). The positive rates of HDV RNA were 4.76%, 8.77%, and 11.63%, respectively, and there was no statistically significant difference among the three groups (χ2=1.221, P=0.543). Clinical outcome, disease course, HBV DNA, serological markers of viral hepatitis, routine blood test, biochemical indicators, coagulation function, and other laboratory indicators were compared between HDV serum marker and/or nucleic acid positive and negative patients, and there was no statistically significant difference (P>0.05). Conclusion: The positive rate of HDV serological markers and HDV RNA is 13.64% and 9.85%, respectively, at a single center in the Xinjiang region, and there is still a high HDV infection rate among the HBV-infected patients with low levels of viral load and HBsAg.
目的： 探讨新疆地区乙型肝炎病毒（HBV）感染者中丁型肝炎病毒（HDV）感染的血清流行病学特点。 方法： 采用单中心横断面分析的方法，选取新疆医科大学第一附属医院感染病·肝病中心自2021年8月至2022年1月住院的264例HBV感染患者，对所有患者均进行了HDV Ag、抗-HDV IgM、抗-HDV IgG和HDV RNA检测，分别依据患者的临床类型、HBV病毒载量、HBsAg水平进行分组，分析HDV的感染状况。计量资料符合正态分布的数据采用配对t检验，治疗前后不符合正态分布的数据采用配对秩和检验。 结果： HDV血清学标志物检测共36例（13.64%）阳性，HDV RNA检测共26例（9.85%）阳性。依据临床类型分组：慢性乙型病毒性肝炎、乙型肝炎相关肝硬化、肝癌以及肝衰竭组患者中，HDV血清学标志物阳性率分别为13.46%、12.43%和20.83%，3组比较，差异无统计学意义（χ2=0.86，P=0.649）；HDV RNA阳性率分别为11.54%、8.11%和20.83%，3组比较，差异无统计学意义（χ2=4.015，P=0.134）。依据HBV病毒载量分组；病毒载量<20 IU/ml、20～2 000 IU/ml和>2 000 IU/ml组患者中，HDV血清学标志物阳性率分别为17.15%、7.81%和6.67%，3组比较，差异无统计学意义（χ2=4.846，P=0.089）；HDV RNA阳性率分别为9.47%、10.94%和10%，3组比较，差异无统计学意义（χ2=0.113，P=0.945）。依据HBsAg水平分组：HBsAg<0.05 IU/ml、0.05～250 IU/ml和>250 IU/ml组的患者中，HDV血清学标志物阳性率分别为14.29%、16.67%和10.85%，3组比较，差异无统计学意义（χ2=1.745，P=0.418）；HDV RNA阳性率分别为4.76%、8.77%和11.63%，3组比较，差异无统计学意义（χ2=1.221，P=0.543）。对HDV血清学标志物和/或HDV RNA阳性与阴性患者人群的临床结局、病程、HBV DNA、病毒性肝炎血清学标志物、血常规、生化指标、凝血功能等实验室指标进行的比较，差异均无统计学意义（P值均＞0.05）。 结论： 新疆地区单中心HDV血清学标志物阳性率为13.64%，HDV RNA阳性率为9.85%，在低病毒载量以及HBsAg低水平的HBV感染者中，仍有较高的HDV感染率。.