Clinical and serological outcome of acute delta infection.
To assess the clinical and serological outcome of hepatitis delta virus (HDV) infection, 59 patients with acute delta hepatitis were followed for 6-28 months. Forty-two patients had simultaneous HDV and HBV coinfection (anti-HBc IgM-positive, group I) and 17 were HBsAg carriers with HDV superinfection (anti-HBc IgM-negative, group II). Overall, serum HD-Ag and anti-HD IgM were the most sensitive markers for diagnosis of delta infection during the first 2 weeks after onset of symptoms. The clinical presentation was similar in both groups; 4 patients (1 in group I and 3 in group II) (7%) developed fulminant hepatitis, but none of them died. The majority of patients with HBV-HDV coinfection (group I) eventually recovered, whereas all HBsAg carriers with HDV superinfection (group II) developed chronic liver disease. Liver histology in these patients showed chronic active hepatitis and/or cirrhosis in 90%. The hepatic lesion was probably due to persistent HDV infection, as indicated by the presence of intrahepatic HD-Ag and/or persistence of serum anti-HD IgM in 90% of the patients.
Buti
M
M
Department de Medicinia Interna, Ciudad Sanitaria Valle Hebrón, Universidad Autónoma, Barcelona, Spain.
Estebán
R
R
Jardi
R
R
Allende
H
H
Estebán
J I
JI
Genesca
J
J
Guardia
J
J
D000914:Antibodies, Viral / Q000032:analysis; D000956:Antigens, Viral / Q000032:analysis; D006509:Hepatitis B / Q000150:complications; D006514:Hepatitis B Surface Antigens / Q000032:analysis; D003699:Hepatitis D / Q000150:complications / Q000473:pathology / Q000503:physiopathology*; D003698:Hepatitis Delta Virus / Q000276:immunology; D006521:Hepatitis, Chronic / Q000150:complications; D006801:Humans; D007075:Immunoglobulin M / Q000032:analysis; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000150:complications; D011446:Prospective Studies; D013997:Time Factors
D000914:Antibodies, Viral; D000956:Antigens, Viral; D006514:Hepatitis B Surface Antigens; D007075:Immunoglobulin M