Genotypes and viremia of hepatitis B and D viruses are associated with outcomes of chronic hepatitis D patients.
OBJECTIVE
Genotypes and viremia of hepatitis D virus (HDV) and hepatitis B virus (HBV) may be associated with outcomes. This study evaluated the impact of viral genotypes and viremia on outcomes of dual HBV and HDV infection.


METHODS
Viremia and viral genotypes were analyzed in 194 consecutive chronic hepatitis B patients with HDV superinfection and correlated with outcomes.


RESULTS
The numbers of HBV genotype A, B, C, and nonclassified were 4, 57, 23, and 110, respectively. There were 51 genotype I HDV, 74 genotype II HDV, 8 genotype IV HDV, and 61 nonclassified HDV genotype. In a median follow-up of 135 months, 24 progressed to cirrhosis and 41 developed hepatocellular carcinoma. Patients infected with genotype I HDV had a lower remission rate (15.2% vs 40.2%; P = .007) and more adverse outcomes (cirrhosis, hepatocellular carcinoma, or mortality) (52.2% vs 25.0%; P= .005) than those with genotype II HDV. Patients infected with genotype C HBV had a lower remission rate (0 vs 32.1%; P = .005) and more adverse outcomes (70.0% vs 33.9%; P = .005) than those with genotype B HBV. The presence of HBV or HDV viremia was associated with lower remission rates compared with those negative for both (26.4% and 24.3% vs 69.2%; P < .001). In multivariate analysis, age, genotype C HBV, and genotype I HDV were independent factors associated with adverse outcomes.


CONCLUSIONS
In chronic HBV and HDV dual infections, older age, genotype I HDV, and genotype C HBV correlated with adverse outcomes.
Su
Chien-Wei
CW
Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
Huang
Yi-Hsiang
YH
Huo
Teh-Ia
TI
Shih
Hsuan Hui
HH
Sheen
I-Jane
IJ
Chen
Su-Wen
SW
Lee
Pui-Ching
PC
Lee
Shou-Dong
SD
Wu
Jaw-Ching
JC
D000328:Adult; D000704:Analysis of Variance; D015331:Cohort Studies; D004279:DNA, Viral / Q000235:genetics*; D018450:Disease Progression; D005260:Female; D005786:Gene Expression Regulation; D005819:Genetic Markers; D020022:Genetic Predisposition to Disease; D005838:Genotype; D019694:Hepatitis B, Chronic / Q000453:epidemiology / Q000235:genetics* / Q000503:physiopathology; D019701:Hepatitis D, Chronic / Q000453:epidemiology / Q000235:genetics* / Q000503:physiopathology; D006801:Humans; D015994:Incidence; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011336:Probability; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D015996:Survival Rate; D013624:Taiwan / Q000453:epidemiology; D014766:Viremia / Q000453:epidemiology / Q000235:genetics* / Q000503:physiopathology
D004279:DNA, Viral; D005819:Genetic Markers