Prevalence of Hepatitis Delta Virus Co-Infection Among Hepatitis B Surface Antigen-Positive Patients in Edo State

Hepatitis Delta Virus (HDV), a defective RNA virus that requires HBV co-infection for its replication, is associated with accelerated progression to liver cirrhosis and hepatocellular carcinoma. In Edo State, South South Nigeria, where HBV prevalence is significant, the burden of HDV co-infection is poorly characterised. This study determines the prevalence of HDV co-infection among HBsAg-positive patients attending the University of Benin Teaching Hospital (UBTH), Benin City. A cross-sectional study will recruit 250 HBsAg-positive patients from the hepatology and gastroenterology outpatient clinics. Serum samples will be tested for anti-HDV total antibodies using ELISA, with reactive samples confirmed by anti-HDV IgM and HDV RNA PCR. Clinical parameters including HBV DNA levels, liver function tests, ultrasound findings, and fibrosis scores will be compared between HDV-positive and HDV-negative groups. Global estimates suggest HDV superinfects 5 to 10 percent of HBV-positive individuals, with higher rates in intravenous drug-using populations. Nigerian HDV data are largely confined to studies from the 1990s, creating an urgent evidence gap. Findings will establish current HDV co-infection prevalence at UBTH and characterise the clinical impact of co-infection in Edo State, informing hepatology protocols for comprehensive viral hepatitis work-up. Keywords: Hepatitis Delta Virus, HBV co-infection, prevalence, Edo State, liver disease