Serological response to the hepatitis delta virus in hepatitis D.
Sera from 74 hepatitis B surface antigen-positive individuals, who presented with acute hepatitis delta virus (HDV) infection which ran a self-limited course in 58 and progressed to chronicity in 16, were tested over time for HDV markers. In self-limited disease the serum pattern varied from early HD-antigenaemia followed by IgM and IgG anti-HD seroconversion, to the appearance of IgM and IgG anti-HD without antigenaemia, or the isolated expression of either the IgM or the IgG antibody. The typical case of IgM anti-HD was transient and appeared with a mean delay of 10-15 days from admission in the different serological subgroups. The IgG antibody usually developed several weeks later during convalescence. In contrast, patients with disease destined to become chronic had a brisk IgM antibody response and IgG anti-HD was detectable with a mean delay of 15 days; generally, the IgM and the IgG antibody persisted over the follow-up time. IgM antibody to HDV is often the only serological test positive in the clinical stage of hepatitis D and repeated testing for this marker is necessary to diagnose acute HDV co-infection. The serological follow-up provides important prognostic information: waning of IgM confirms resolution of HDV infection, persistence predicts chronicity.
D000208:Acute Disease; D000956:Antigens, Viral / Q000032:analysis; D002908:Chronic Disease; D005500:Follow-Up Studies; D006508:Hepatitis Antibodies / Q000032:analysis*; D006509:Hepatitis B / Q000150:complications; D006514:Hepatitis B Surface Antigens / Q000276:immunology; D003699:Hepatitis D / Q000276:immunology*; D003698:Hepatitis Delta Virus / Q000276:immunology*; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D007075:Immunoglobulin M / Q000032:analysis; D011379:Prognosis; D011863:Radioimmunoassay; D013997:Time Factors
D000956:Antigens, Viral; D006508:Hepatitis Antibodies; D006514:Hepatitis B Surface Antigens; D007074:Immunoglobulin G; D007075:Immunoglobulin M