Long-term delta superinfection in hepatitis B surface antigen carriers and its relationship to the course of chronic hepatitis.
To assess the prevalence and clinical significance of delta-infection in chronic hepatitis B surface antigen carriers, we examined 326 liver biopsies from 192 retrospectively selected carriers by immunofluorescence. Delta antigen was detected in 102 specimens from 50 carriers (26.2%) with peak prevalence in patients with active cirrhosis (51.5%) and generally in close association with progressive liver disease (94%). The antigen was located in the nuclei of 2%-50% of the hepatocytes, without any disease-specific pattern of fluorescence. Patients with intrahepatic delta-antigen, however, had more severe liver disease than those without it. Histologic follow-up of 101 cases showed that the rates of worsening of the liver disease were similar in delta-antigen-positive and in delta-antigen-negative patients. It is concluded that delta-superinfection does play a role in worsening the histologic picture of hepatitis B surface antigen-positive chronic active hepatitis, possibly by liver injury induced acutely at the moment of infection.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000954:Antigens, Surface / Q000032:analysis*; D002353:Carrier State / Q000276:immunology*; D002467:Cell Nucleus / Q000276:immunology; D002648:Child; D002908:Chronic Disease; D005260:Female; D005455:Fluorescent Antibody Technique; D005500:Follow-Up Studies; D006509:Hepatitis B / Q000276:immunology* / Q000473:pathology; D006511:Hepatitis B Antigens / Q000032:analysis*; D035923:Hepatitis delta Antigens; D006801:Humans; D008103:Liver Cirrhosis / Q000276:immunology / Q000473:pathology; D008297:Male; D008875:Middle Aged
D000954:Antigens, Surface; D006511:Hepatitis B Antigens; D035923:Hepatitis delta Antigens