title: Comparative analysis of disease activity in patients of chronic hepatitis B virus, with and without superinfection with hepatitis D virus; an experience at tertiary care centre.
abstract: BACKGROUND
  The hepatitis D virus super-infection contributes significantly to the morbidity and mortality of hepatitis B virus infection. The objectives were to describe the incidence of Hepatitis D virus and comparative analysis of disease activity in patients of chronic hepatitis B virus, with and without super-infection of hepatitis D virus.
  
  
  METHODS
  This Cross-sectional comparative study was conducted at Department of Medicine and Gastroenterology Clinic Jinnah Postgraduate Medical Centre, Karachi, Pakistan from February 2007 to July 2007. HBsAg positive patients who attended our Gastroenterology clinic were selected for the study. After screening for Anti-HDV these patients were segregated in to Anti-HDV positive and negative groups. Data was analyzed on SPSS 12.
  
  
  RESULTS
  Eighty-four patients were selected. Seventy-three patients who fulfilled the inclusion criteria were enrolled in to the study. Anti-HDV was positive in 23 (31.5%) patients. Among these 23 anti-HDV positive, HDV-RNA was detected in 15 (75%) patients. The differences of age, gender, marital status and area of residence whether rural or urban were not significant between the two groups. HBV-DNA was significantly suppressed in majority of anti-HDV positive patients (p = 0.019). Mean serum ALT levels were significantly higher in patients who had HDV infection (p = 0.014).
  
  
  CONCLUSIONS
  HDV infection was common in this series of patients with a frequency of 31.5%. All patients of chronic HBV should be screened for HDV whether they are asymptomatic HBV carriers or have chronic active hepatitis particularly when they have raised serum ALT.
authors.affiliation: Department of Medicine and Gastroenterlogy Clinic, Jinnah Postgraduate Medical Centre, Karachi. kirpalmakheja@yahoo.com
authors.forename: Kirpal
authors.initials: K
authors.lastname: Das
authors.forename: Hassan
authors.initials: H
authors.lastname: Ali
authors.forename: Tariq
authors.initials: T
authors.lastname: Mahmood
authors.forename: S M
authors.initials: SM
authors.lastname: Munir
authors.forename: Tabinda
authors.initials: T
authors.lastname: Ahmed
authors.forename: Muhammad Umar
authors.initials: MU
authors.lastname: Farooq
mesh_terms: D000293:Adolescent; D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D002648:Child; D003430:Cross-Sectional Studies; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006508:Hepatitis Antibodies / Q000097:blood; D006514:Hepatitis B Surface Antigens / Q000032:analysis; D006513:Hepatitis B e Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification; D019694:Hepatitis B, Chronic / Q000175:diagnosis / Q000453:epidemiology* / Q000635:transmission; D019701:Hepatitis D, Chronic / Q000175:diagnosis / Q000453:epidemiology* / Q000635:transmission; D003698:Hepatitis Delta Virus / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification; D035923:Hepatitis delta Antigens / Q000276:immunology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010154:Pakistan / Q000453:epidemiology; D055815:Young Adult
chemical_list: D004279:DNA, Viral; D006508:Hepatitis Antibodies; D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens; D035923:Hepatitis delta Antigens; D000410:Alanine Transaminase