how hepatitis d virus can hinder the control of hepatitis b virusd型肝炎病毒如何阻碍了乙型肝炎病毒的控制.pdfVIP

How Hepatitis D Virus Can Hinder the Control of Hepatitis B Virus 1 1¤ 2 1,3 Maria Xiridou *, Barbara Borkent-Raven , Joost Hulshof , Jacco Wallinga 1 Centre for Infectious Diseases Control, National Institute of Public Health and the Environment, Bilthoven, The Netherlands, 2 Department of Mathematics, VU University Amsterdam, Amsterdam, The Netherlands, 3 Julius Center for Health Research and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands Abstract Background: Hepatitis D (or hepatitis delta) virus is a defective virus that relies on hepatitis B virus (HBV) for transmission; infection with hepatitis D can occur only as coinfection with HBV or superinfection of an existing HBV infection. Because of the bond between the two viruses, control measures for HBV may have also affected the spread of hepatitis D, as evidenced by the decline of hepatitis D in recent years. Since the presence of hepatitis D is associated with suppressed HBV replication and possibly infectivity, it is reasonable to speculate that hepatitis D may facilitate the control of HBV. Methodology and Principal Findings: We introduced a mathematical model for the transmission of HBV and hepatitis D, where individuals with dual HBV and hepatitis D infection transmit both viruses. We calculated the reproduction numbers of single HBV infections and dual HBV and hepatitis D infections and examined the endemic prevalences of the two viruses. The results show that hepatitis D virus modulates not only the severity of the HBV epidemic, but also the impact of interventions for HBV. Surprisingly we find that the presence of hepatitis D virus may hamper the eradication of HBV. Interventions that aim to reduce the basic reproduction numb