title: Prevalence and clinical significance of hepatitis D virus co-infection in patients with chronic hepatitis B in Korea.
abstract: Hepatitis D virus (HDV) infection can cause severe acute and chronic liver disease in patients infected with hepatitis B virus (HBV). Despite the significant decline in the global HDV infection, it remains a major health concern in some countries. This study aimed to investigate the prevalence and clinical features of HDV co-infection in patients with chronic HBV infection in Korea, where HBV infection is endemic. Nine hundred forty patients [median age, 48 (18-94) years; men, 64.5%] infected chronically with HBV were enrolled consecutively. All patients who were positive for hepatitis B surface antigen (HBsAg) for at least 6 months and were tested for anti-HDV. A portion of the HDV delta antigen was amplified, sequenced, and subjected to molecular and phylogenetic analysis using sera from the patients who were anti-HDV positive. Clinical features and virologic markers were evaluated. Inactive HBsAg carriers, chronic hepatitis B, cirrhosis and hepatocellular carcinoma accounted for 29.5%, 44.7%, 17.9%, and 8.0%, respectively. Only three patients were positive for anti-HDV, corresponding to a 0.32% positive rate. All patients who were positive for anti-HDV were inactive HBsAg carriers. HDV RNA could be amplified by PCR from the sera of two patients. Phylogenetic analysis showed that both carried HDV genotype 1. In conclusion, the prevalence of HDV infection is very low (0.32%) in Korea. All HDVs were genotype 1 and detected in inactive HBsAg carriers. Therefore, HDV co-infection may not have a significant clinical impact in Korean patients with chronic HBV infection.
authors.affiliation: Department of Internal Medicine, Kangdong Sacred Heart Hospital of Hallym University Medical Center, Seoul, Republic of Korea.
authors.forename: Hyoung Su
authors.initials: HS
authors.lastname: Kim
authors.forename: Sung Jun
authors.initials: SJ
authors.lastname: Kim
authors.forename: Hye Won
authors.initials: HW
authors.lastname: Park
authors.forename: Woon Geon
authors.initials: WG
authors.lastname: Shin
authors.forename: Kyung Ho
authors.initials: KH
authors.lastname: Kim
authors.forename: Jin Heon
authors.initials: JH
authors.lastname: Lee
authors.forename: Hak Yang
authors.initials: HY
authors.lastname: Kim
authors.forename: Myoung Kuk
authors.initials: MK
authors.lastname: Jang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D005838:Genotype; D006508:Hepatitis Antibodies / Q000097:blood / Q000235:genetics / Q000276:immunology; D006514:Hepatitis B Surface Antigens / Q000032:analysis / Q000097:blood / Q000276:immunology; D006515:Hepatitis B virus / Q000235:genetics / Q000276:immunology; D019694:Hepatitis B, Chronic / Q000097:blood / Q000150:complications* / Q000453:epidemiology / Q000235:genetics / Q000276:immunology; D003699:Hepatitis D / Q000097:blood / Q000150:complications* / Q000453:epidemiology / Q000235:genetics / Q000276:immunology; D003698:Hepatitis Delta Virus / Q000235:genetics* / Q000276:immunology; D006801:Humans; D008103:Liver Cirrhosis / Q000453:epidemiology / Q000235:genetics / Q000276:immunology; D008113:Liver Neoplasms / Q000150:complications* / Q000453:epidemiology / Q000235:genetics / Q000276:immunology; D008297:Male; D008875:Middle Aged; D010802:Phylogeny; D015995:Prevalence; D056910:Republic of Korea; D055815:Young Adult
chemical_list: D004279:DNA, Viral; D006508:Hepatitis Antibodies; D006514:Hepatitis B Surface Antigens