Archives of Virology

, Volume 157, Issue 4, pp 647–659 | Cite as

Current hepatitis delta virus type 1 (HDV1) infections in central and eastern Turkey indicate a wide genetic diversity that is probably linked to different HDV1 origins

  • Frédéric Le Gal
  • Selim Badur
  • Nasser Al Hawajri
  • Filiz Akyüz
  • Sabahattin Kaymakoglu
  • Ségolène Brichler
  • Fabien Zoulim
  • Emmanuel Gordien
  • Elyanne Gault
  • Paul Dény
Original Article


Hepatitis delta virus (HDV) is a subviral pathogen of humans, a satellite of hepatitis B virus (HBV) that induces severe acute and chronic liver diseases. The genus Deltavirus consists of eight clades or genotypes, with HDV1 being ubiquitous and frequently characterized. In Turkey, HDV1 infection is highly endemic among HBsAg carriers, especially in the southeastern region. In this study, we analyzed 34 samples from patients who were chronically infected with HBV/HDV, originating from 22 cities of rural regions in the central and eastern parts of Turkey, in order to determine the levels of viral replication and genetic diversity. HDV RNA levels ranged between 3.02 and 8.75 Log copies/mL, and HBV DNA was detected in 25 samples (73.5%), with values ranging from 2.53 to 5.30 Log copies/mL. Analysis of nucleotides 900-1280 of HDV genomes (n = 34) and full-length (n = 17) sequences indicated that all of the strains belonged to genotype HDV1. However, a high genetic diversity was observed among the isolates, with a mean full-length dissimilarity score of 13.05%. HDV sequences clustered with sequences from Western Europe (n = 11), Eastern Europe and Asia (n = 19) or Africa (n = 4). HDV1 isolates related to strains of African origin had a serine residue instead of an alanine at position 202 of the large delta protein. HBV preS1 sequences obtained for 34 isolates indicated an HBV/D genotype in all cases. Taken together, our results indicate that in Turkey, where HBV-HDV dual infection is highly endemic, both viruses have high levels of replication, and HDV strains exhibit wide genetic diversity, which might reflect ancient evolution and/or successive outbreaks.


Hepatitis Delta Virus Hepatitis Delta Virus Infection Chronic Delta Hepatitis Hepatitis Delta Virus Replication Hepatitis Delta Virus Genome 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



We thank Ms. S. Oymac for preliminary work on Turkish samples. We thank the reviewers for their comments. This work was supported by INSERM, Agence Nationale de Recherche sur le Sida et les Hepatites Virales (ANRS), Institut de Veille Sanitaire, Assistance Publique - Hôpitaux de Paris, University Paris 13, and the Faculty of Medicine of Istanbul.

Conflict of interest

None of the authors report a conflict of interest.

Supplementary material

705_2011_1212_MOESM1_ESM.docx (13 kb)
Supplementary material 1 (DOCX 13 kb)


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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Frédéric Le Gal
    • 1
  • Selim Badur
    • 2
  • Nasser Al Hawajri
    • 1
    • 3
  • Filiz Akyüz
    • 4
  • Sabahattin Kaymakoglu
    • 4
  • Ségolène Brichler
    • 1
  • Fabien Zoulim
    • 6
  • Emmanuel Gordien
    • 1
  • Elyanne Gault
    • 1
    • 5
  • Paul Dény
    • 1
    • 6
  1. 1.Service de Bactériologie, Virologie-HygièneHôpital Avicenne, Assistance Publique, Hôpitaux de Paris, Laboratoire associé au Centre National de Référence des Hépatites B, C et deltaBobignyFrance
  2. 2.Division of Virology and Immunology, Department of MicrobiologyIstanbul University School of MedicineIstanbulTurkey
  3. 3.Bioinformatique et Biostatistique, Unité de Recherche Clinique de Créteil-Paris XII, Hôpital Henri MondorCréteilFrance
  4. 4.Department of GastroenterohepatologyIstanbul University School of MedicineIstanbulTurkey
  5. 5.Université de Versailles St-Quentin-en-Yvelines, UPRES EA3647GuyancourtFrance
  6. 6.Centre de Recherches en Cancérologie de Lyon, INSERM, U1052, UMR CNRS 5286Lyon cedex 03France

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