Hepatitis B virus and hepatitis D virus replication in HBsAg-positive fulminant hepatitis.
Hepatitis B virus DNA and hepatitis D virus RNA, the most sensitive markers of hepatitis B and hepatitis D virus replication, were sought by molecular hybridization with radioactive probes in serial serum samples from 29 consecutive patients with HBsAg-positive fulminant hepatitis. Nineteen patients had evidence of hepatitis D virus infection, as assessed by the presence in serum of delta antigen, anti-delta antibodies, or both. Hepatitis B virus DNA was found in only two patients: one was a chronic HBsAg carrier with hepatitis D virus superinfection and the other had fulminant hepatitis caused by hepatitis B and hepatitis D coinfection. Hepatitis D virus RNA was detected in three patients: two with hepatitis B and hepatitis D coinfection and also in the HBsAg carrier with positive hepatitis B virus DNA and hepatitis D virus superinfection. None of 10 patients with hepatitis B virus infection alone had detectable viral nucleic acids in serum. Overall, viral nucleic acids were detected in the sera of 4 of the 29 patients (14%). Hepatitis D virus antigenemia did not indicate hepatitis D virus replication because hepatitis D virus RNA was not detected in 9 of 12 patients with hepatitis D virus antigen in their sera. The low frequency of viral replication found in fulminant hepatitis B or D may explain the low recurrence rate of viral hepatitis in patients with fulminant hepatitis who have received liver transplantations.
Mas
A
A
Liver Unit, Hospital Clínic, Universitat de Barcelona, Spain.
Buti
M
M
Esteban
R
R
Sánchez-Tapias
J M
JM
Costa
J
J
Jardí
R
R
Bruguera
M
M
Guardia
J
J
Rodés
J
J
D000293:Adolescent; D000328:Adult; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006505:Hepatitis / Q000097:blood / Q000276:immunology* / Q000401:mortality; D006514:Hepatitis B Surface Antigens / Q000032:analysis*; D006515:Hepatitis B virus / Q000502:physiology*; D003698:Hepatitis Delta Virus / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000032:analysis; D012698:Serologic Tests; D016019:Survival Analysis; D014779:Virus Replication
D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens; D012367:RNA, Viral