title: The epidemiology and clinical outcome of hepatitis D virus (delta) infection in Jordan.
abstract: The epidemiology and clinical outcome of hepatitis D viral infection in HBsAg-positive acute hepatitis, chronic liver disease, primary hepatocellular carcinoma and the symptomless carrier state was studied in Jordan. The prevalence of hepatitis D viral infection was significantly higher in patients with chronic liver disease (18/79, 23%) and acute hepatitis (17/108, 16%) than in symptomless HBsAg carriers (2/136, 2%). The highest prevalence of hepatitis D viral infection was found in patients with primary hepatocellular carcinoma (10/15, 67%) who were also significantly older than such patients without hepatitis D viral infection. Antihepatitis D virus IgM was detected persistently in 83% of patients with antihepatitis D virus-positive chronic liver disease and transiently in 41% of patients with acute hepatitis. A trend to increased mortality was observed in acute hepatitis D viral superinfection (25%) compared to hepatitis D viral coinfection (0%) and to antihepatitis D virus-negative HBsAg-positive acute hepatitis (4%). In patients with established chronic liver disease, however, neither survival nor histological parameters of disease activity were significantly different in the antihepatitis D virus-positive and antihepatitis D virus-negative groups. While the early stage of hepatitis D viral superinfection is associated with increased mortality, it appears that in patients with late-stage chronic liver disease, severe histological activity subsides, and survival is no longer influenced by the factor of hepatitis D viral infection. However, primary hepatocellular carcinoma appears to complicate the course of those antihepatitis D virus-positive patients surviving beyond this stage.
authors.affiliation: Department of Medicine, Jordan University Hospital, Faculty of Medicine, Amman.
authors.forename: A U
authors.initials: AU
authors.lastname: Toukan
authors.forename: O A
authors.initials: OA
authors.lastname: Abu-el-Rub
authors.forename: S A
authors.initials: SA
authors.lastname: Abu-Laban
authors.forename: M S
authors.initials: MS
authors.lastname: Tarawneh
authors.forename: M F
authors.initials: MF
authors.lastname: Kamal
authors.forename: S C
authors.initials: SC
authors.lastname: Hadler
authors.forename: K
authors.initials: K
authors.lastname: Krawczynski
authors.forename: H S
authors.initials: HS
authors.lastname: Margolis
authors.forename: J E
authors.initials: JE
authors.lastname: Maynard
mesh_terms: D000208:Acute Disease; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000276:immunology; D002353:Carrier State / Q000150:complications / Q000276:immunology; D002908:Chronic Disease; D006509:Hepatitis B / Q000150:complications / Q000276:immunology; D006514:Hepatitis B Surface Antigens / Q000032:analysis; D003699:Hepatitis D / Q000150:complications / Q000453:epidemiology* / Q000276:immunology; D006801:Humans; D007597:Jordan; D008107:Liver Diseases / Q000150:complications / Q000276:immunology; D008113:Liver Neoplasms / Q000150:complications / Q000276:immunology; D011379:Prognosis
chemical_list: D006514:Hepatitis B Surface Antigens