Survival and complications in a cohort of patients with anti-delta positive liver disease presenting in a tertiary referral clinic.
OBJECTIVE
Our aim was to evaluate the clinical outcome and survival of patients with anti-Delta positive liver disease in The Netherlands.


METHODS
We evaluated those patients visiting our hospital between 1978 and 1993 with respect to clinical, virological and histological parameters. During the follow-up period the occurrence of complications of the liver disease and survival was determined. Thirty patients with a median age of 34 years (range 21-52) were included.


RESULTS
During an average follow up of 4.8 years, nine patients died. The overall 5-year survival as estimated by Kaplan-Meyer analysis was 71%, which was comparable to hepatitis B cirrhosis patients. However, in the group without active hepatitis B replication (HBeAg-negative) a clear trend towards a worse survival was identified in Delta cirrhosis patients. Complications and deaths occurred exclusively in the patient group with cirrhotic liver disease. The complications (ascites, elevated bilirubin >34 micro mol/l), variceal bleeding and spontaneous bacterial peritonitis) occurred in 52% of the patients with a follow up of more than 6 months (n=27). Fifty-seven percent of those patients died. In our population anti-Delta positive liver disease affects predominantly young patients and is related to advanced liver disease.


CONCLUSIONS
In view of the high death rate, liver transplantation should be considered when signs or symptoms of decompensated liver disease occur.
de Man
R A
RA
Department of Internal Medicine II, Erasmus University, Rotterdam, The Netherlands.
Sprey
R P
RP
Niesters
H G
HG
Heijtink
R A
RA
Zondervan
P E
PE
Hop
W
W
Schalm
S W
SW
D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D001483:Base Sequence; D005260:Female; D003699:Hepatitis D / Q000150:complications / Q000401:mortality* / Q000473:pathology; D003698:Hepatitis Delta Virus / Q000235:genetics / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000032:analysis; D015996:Survival Rate
D000914:Antibodies, Viral; D012367:RNA, Viral