Seropositivity for delta hepatitis in patients with chronic hepatitis B and liver cirrhosis in Turkey: a meta-analysis
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Background: Recent reports suggest a decline of delta hepatitis (DH) in the West as well as in the Far East. Aim: To study the DH seroepidemiology in Turkey. Methods: Statistical power analysis was utilized based on data available in a recent article using prevalence figure estimates. Binominal distribution was applied in order to assess the number of samples required to estimate the prevalence with a given precision. Results: Out of 62 studies in the original study, 32 were eliminated because of insufficient power. A total of 6734 patients (5231 with chronic hepatitis and 1503 with cirrhosis) were analysed. Anti-HDV seropositivity among patients with chronic hepatitis B (CHB) and hepatitis B-induced cirrhosis was lowest in the west of the country and highest in the southeast (5 vs. 27%, P < 0.0001 and 20 vs. 46%, P < 0.0001) respectively. Compared with data obtained before 1995, after 1995, DH prevalence in patients with CHB and cirrhosis decreased from 29 to 12% (P < 0.0001) and from 38 to 27% (P=0.03) in central and southeast Turkey and from 38 to 20% (P < 0.0001) and from 66 to 46% (P < 0.002) in west and southeast Turkey respectively. Conclusion: Despite the decrease of its prevalence in Turkey, DH remains a significant health problem in parts of the country with low socio-economic level.