Volume 75, Issue 3
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


In Brazil, hepatitis delta virus (HDV) is only reported in Western Amazonia, where severe cases of acute and chronic HDV hepatitis have been described. The study area was chosen in the States of Acre and Rondonia where most cases of hepatitis B virus (HBV)/HDV are reported. From December 2003 to October 2004, 40 HBsAg carriers with anti-HDV IgM were selected. An epidemiologic questionnaire, including demographic and clinical/epidemiologic variables was filled out. HDV amplification and genotyping were performed. Genotype I was detected in 22 patients (55.0%), whereas genotype III was identified in 18 (45.0%). Patients who were infected with genotype I were older (45.1 ± 17.8 years) than patients infected with genotype III (32.8 ± 10.9 years; = 0.01). No symptoms were reported by 21 (52.5%) patients. Otherwise, 19 (47.5%) had symptoms (fatigue, abdominal pain, weight loss, and decompensated liver disease) that motivated them to seek medical care. Genotype III carriers were more symptomatic, but no statistical significance was achieved. Our preliminary results show that HDV genotypes I and III are present in Brazilian Amazonia and that HDV genotype III is not limited to the Amerindian population.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. Rizzetto M, Canese M, Aroci S, Crivelli O, Trépo C, Bonino F, Verme G, 1977. Immunofluorescence detection of a new antigen-antibody system (Delta/anti-Delta) associated with hepatitis B virus in liver and serum of HBsAg carriers. Gut 18 : 997–1003. [Google Scholar]
  2. Gaeta GB, Stroffolini T, Chiaramonte M, Ascione T, Stornaiuolo G, Lobello S, Sagnelli E, Brunetto MR, Rizzetto M, 2000. Chronic hepatitis D: A vanishing disease? An Italian multi-center study. Hepatology 32 : 824–827. [Google Scholar]
  3. Bensabath G, Hadler SC, Soares MC, Fields H, Dias LB, Popper H, Maynard JE, 1987. Hepatitis delta virus infection and Labrea hepatitis. Prevalence and role in fulminant hepatitis in the Amazon Basin. JAMA 258 : 479–483. [Google Scholar]
  4. Bensabath G, Dias LB, 1983. Labrea hepatitis (Labrea black fever) and other fulminant forms of hepatitis in Sena Madureira. Rev Inst Med Trop Sao Paulo 25 : 182–194. [Google Scholar]
  5. Fonseca JC, Simonetti SR, Schatzmayr HG, Castejon MJ, Cesario AL, Simonetti JP, 1988. Prevalence of infection with hepatitis delta virus (HDV) among carriers of hepatitis B surface antigen in Amazonas State, Brazil. Trans R Soc Trop Med Hyg 82 : 469–471. [Google Scholar]
  6. Fonseca JC, 2002. Hepatitis D. Rev Soc Bras Med Trop 35 : 181–190. [Google Scholar]
  7. Casey JL, Brown TL, Colan EJ, Wignall FS, Gerin JL, 1993. A genotype of hepatitis D virus that occurs in northern South America. Proc Natl Acad Sci USA 90 : 9016–9020. [Google Scholar]
  8. Chao YC, Chang MF, Gust I, Lai MM, 1990. Sequence conservation and divergence of hepatitis delta virus RNA. Virology 178 : 384–392. [Google Scholar]
  9. Radjef N, Gordien E, Ivaniushina V, Gault E, Anais P, Drugan T, Trinchet JC, Roulot D, Tamby M, Milinkovitch MC, Deny P, 2004. Molecular phylogenetic analyses indicate a wide and ancient radiation of African hepatitis delta virus, suggesting a deltavirus genus of at least seven major clades. J Virol 78 : 2537–2544. [Google Scholar]
  10. Casey JL, Niro GA, Engle RE, Vega A, Gomez H, McCarthy M, Watts DM, Hyams KC, Gerin JL, 1996. Hepatitis B virus (HBV)/hepatitis D virus (HDV) coinfection in outbreaks of acute hepatitis in the Peruvian Amazon basin: The roles of HDV genotype III and HBV genotype F. J Infect Dis 174 : 920–926. [Google Scholar]
  11. Shakil AO, Hadziyannis S, Hoofnagle JH, Di Bisceglie AM, Gerin JL, Casey JL, 1997. Geographic distribution and genetic variability of hepatitis delta virus genotype I. Virology 234 : 160–167. [Google Scholar]
  12. Quintero A, Uzcategui N, Loureiro CL, Villegas L, Illarramendi X, Guevara ME, Ludert JE, Blitz L, Liprandi F, Pujol FH, 2001. Hepatitis delta virus genotypes I and III circulate associated with hepatitis B virus genotype F In Venezuela. J Med Virol 64 : 356–359. [Google Scholar]
  13. Braga WS, Brasil LM, de Souza RA, Castilho Mda C, da Fonseca JC, 2001. The occurrence of hepatitis B and delta virus infection within seven Amerindian ethnic groups in the Brazilian western Amzon. Rev Soc Bras Med Trop 34 : 349–355. [Google Scholar]
  14. de Paula VS, Arruda ME, Vitral CL, Gaspar AM, 2001. Sero-prevalence of viral hepatitis in riverine communities from the Western Region of the Brazilian Amazon Basin. Mem Inst Oswaldo Cruz 96 : 1123–1128. [Google Scholar]
  15. Ribeiro LC, Souto FJ, 2000. Hepatitis Delta in the State of Mato Grosso, Brazil: report of 5 cases. Rev Soc Bras Med Trop 33 : 599–602. [Google Scholar]
  16. Tavares-Neto J, Almeida D, Soares MC, Uchoa R, Viana S, Darub R, Farias E, Rocha G, Vitvitski L, Parana R, 2004. Seroprevalence of hepatitis B and C in the Western Brazilian Amazon region (Rio Branco, Acre): A pilot study carried out during a hepatitis B vaccination program. Braz J Infect Dis 8 : 133–139. [Google Scholar]
  17. Fonseca JC, Ferreira LC, Brasil LM, Castilho Mda C, Moss R, Barone M, 1992. Fulminant Labrea hepatitis—the role of hepatitis A (HAV), B (HBV), C (HCV), and D (HDV) infection (preliminary report). Rev Inst Med Trop Sao Paulo 34 : 609–612. [Google Scholar]
  18. Andrade ZA, Lesbordes JL, Ravisse P, Parana R, Prata A, Barberino JS, Trepo C, 1992. Fulminant hepatitis with microvesicular steatosis (a histologic comparison of cases occurring in Brazil–Labrea hepatitis–and in central Africa–Bangui hepatitis). Rev Soc Bras Med Trop 25 : 155–160. [Google Scholar]
  19. Manock SR, Kelley PM, Hyams KC, Douce R, Smalligan RD, Watts DM, Sharp TW, Casey JL, Gerin JL, Engle R, Alava-Alprecht A, Martinez CM, Bravo NB, Guevara AG, Russell KL, Mendoza W, Vimos C, 2000. An outbreak of fulminant hepatitis delta in the Waorani, an indigenous people of the Amazon basin of Ecuador. Am J Trop Med Hyg 63 : 209–213. [Google Scholar]
  20. Nakano T, Shapiro CN, Hadler SC, Casey JL, Mizokami M, Orito E, Robertson BH, 2001. Characterization of hepatitis D virus genotype III among Yucpa Indians in Venezuela. J Gen Virol 82 : 2183–2189. [Google Scholar]
  21. Niro GA, Casey JL, Gravinese E, Garrubba M, Conoscitore P, Sagnelli E, Durazzo M, Caporaso N, Perri F, Leandro G, Facciorusso D, Rizzetto M, Andriulli A, 1999. Intrafamilial transmission of hepatitis delta virus: Molecular evidence. J Hepatol 30 : 564–569. [Google Scholar]
  22. Parana R, Lyra L, Trepo C, 1999. Intravenous vitamin complexes used in sporting activities and transmission of HCV in Brazil. Am J Gastroenterol 94 : 857–858. [Google Scholar]
  23. Viana S, Parana R, Moreira RC, Compri AP, Macedo V, 2005. High prevalence of hepatitis B virus and hepatitis D virus in the western Brazilian Amazon. Am J Trop Med Hyg 73 : 808–814. [Google Scholar]
  24. Parana R, Almeida D, 2005. HBV epidemiology in Latin America. J Clin Virol 34 (Suppl 1): S130–S133. [Google Scholar]
  25. Cheng Q, Jayan GC, Casey JL, 2003. Differential inhibition of RNA editing in hepatitis delta virus genotype III by the short and long forms of hepatitis delta antigen. J Virol 77 : 7786–7795. [Google Scholar]

Data & Media loading...

  • Received : 29 Jan 2006
  • Accepted : 07 Apr 2006

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error