Quantitative HBsAg and HDV-RNA levels in chronic delta hepatitis.
Abstract Background: Hepatitis delta virus (HDV) causes severe liver disease.


OBJECTIVE
To investigate the quantitative HDV-RNA, HBsAg and hepatitis B virus (HBV)DNA levels in correlation to histological, biochemical and demographical parameters in patients with chronic HDV infection as similar data in a large series of HDV patients are missing.


METHODS
Eighty HDV patients were recruited in Germany, Turkey and Greece; quantitative determination of HDV-RNA, HBsAg and HBV-DNA was performed by real-time polymerase chain reaction, the Architect HBsAg assay and Cobas TaqMan HBV test respectively.


RESULTS
All patients were infected with HDV-genotype 1. Thirty-five patients (48%) had significant fibrosis (Ishak 3-4) and 15 (20.5%) had cirrhosis. HDV viraemia ranged from 1.1 x 10(3) to 8.4 x 10(7) copies/ml with 60% of patients showing HDV-RNA levels above 10(5) copies/ml accompanied by low HBV viraemia (<10(5) copies/ml). However, HDV-RNA and HBV-DNA levels showed no direct inverse correlation. HDV-RNA correlated positively with HBsAg and negatively with age. HBsAg correlated negatively with age and positively with histological grading. Only gamma-glutamyltranspeptidase was independently associated with cirrhosis (P=0.032), while no biochemical parameter was associated with grading.


CONCLUSIONS
(i) HBsAg levels correlated with HDV viraemia in chronic HDV. (ii) Biochemical parameters did not accurately indicate the stage and grade of liver disease in chronic HDV and thus liver biopsy seems to remain the major tool for the evaluation of delta hepatitis patients.
Zachou
Kalliopi
K
Department of Gastroenterology, Hepatology and Endocrinology, Hanover Medical School, Hanover, Germany.
Yurdaydin
Cihan
C
Drebber
Uta
U
Dalekos
George N
GN
Erhardt
Andreas
A
Cakaloglu
Yilmaz
Y
Degertekin
Halil
H
Gurel
Selim
S
Zeuzem
Stefan
S
Bozkaya
Hakan
H
Schlaphoff
Verena
V
Dienes
Hans P
HP
Bock
Thomas C
TC
Manns
Michael P
MP
Wedemeyer
Heiner
H
D000293:Adolescent; D000328:Adult; D004279:DNA, Viral / Q000097:blood*; D005260:Female; D006514:Hepatitis B Surface Antigens / Q000097:blood*; D006515:Hepatitis B virus / Q000235:genetics*; D019701:Hepatitis D, Chronic / Q000150:complications / Q000473:pathology / Q000821:virology*; D003698:Hepatitis Delta Virus / Q000235:genetics*; D006801:Humans; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000209:etiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood*; D014766:Viremia; D055815:Young Adult
D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens; D012367:RNA, Viral