Hepatitis D virus RNA in acute delta infection: serological profile and correlation with other markers of hepatitis D virus infection.
To evaluate the profile of hepatitis D virus replication and the corresponding immunoresponse after acute hepatitis D virus infection, sera from 50 patients with acute hepatitis D (36 with acute hepatitis B virus-hepatitis D virus coinfection and 14 HBsAg carriers with hepatitis D virus superinfection) were investigated for the presence of hepatitis D virus RNA and other serological hepatitis D virus markers. During the first week after onset of symptoms, hepatitis D virus RNA was detected by spot hybridization with a similar frequency among patients with coinfection (64%) and those with superinfection (71%). The presence of hepatitis D virus RNA in the first serum sample correlated with that of circulating hepatitis D antigen in both groups of patients. The presence of hepatitis D virus RNA was transient and its clearance paralleled that of serum hepatitis D antigen among patients with coinfection, so that 1 month after the onset of symptoms serum hepatitis D virus RNA was no longer detectable in any of these patients. Conversely, serum hepatitis D virus RNA was still present in 78% of those with superinfection, all of whom developed chronic liver disease, thus suggesting that the persistence of hepatitis D virus RNA in the serum for more than 4 weeks might indicate progression to chronicity. In nine of the 14 patients (64%) with hepatitis D virus superinfection progressing to chronicity, hepatitis D virus RNA was persistently detected throughout the follow-up, whereas in five patients it was detected occasionally. In four superinfected patients hepatitis D virus RNA and hepatitis B virus DNA were detected simultaneously in serial samples, thus suggesting that, at least during early stages of chronic hepatitis D virus infection, both viruses may replicate at the same time.
Ciudad Sanitaria Valle de Hebrón, Universidad Autónoma, Barcelona, Spain.
M
M
Buti
R
R
Esteban
M
M
Roggendorf
J
J
Fernandez
R
R
Jardi
R
R
Rashofer
H
H
Allende
J
J
Genesca
J I
JI
Esteban
J
J
Guardia
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D004279:DNA, Viral / Q000097:blood; D005260:Female; D006509:Hepatitis B / Q000175:diagnosis; D006514:Hepatitis B Surface Antigens / Q000032:analysis; D006515:Hepatitis B virus / Q000235:genetics; D003699:Hepatitis D / Q000175:diagnosis*; D003698:Hepatitis Delta Virus / Q000235:genetics*; D006801:Humans; D008297:Male; D009693:Nucleic Acid Hybridization; D011446:Prospective Studies; D012367:RNA, Viral / Q000097:blood*; D011863:Radioimmunoassay; D013997:Time Factors
D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens; D012367:RNA, Viral