Retrospective analysis of chronic hepatitis D in a West German University Clinic over two decades: migratory pattern, prevalence and clinical outcome.

Abstract

BACKGROUND/AIMS:

Epidemiology, clinical features and long term-course of chronic hepatitis D were addressed in a non-endemic Central European area.

METHODS:

Sixty-seven patients with chronic hepatitis D were identified among 1307 HBsAg carriers at the university hospital Düsseldorf during two decades (1989 - 2008) and followed for a mean of 7 +/- 6 years. Forty-one of these were treated with IFN-alfa for at least six months.

RESULTS:

Hepatitis D prevalence increased from 4.1 to 6.2 % among HBsAg carriers during the two decades (p < 0.06). Patients originating from the former Soviet Union (32.1 vs. 46.2 %) and Africa (0 vs. 17.9 %) became more frequent whereas the prevalence of patients from Southern Europe declined (46.5 vs.17.9 % p < 0.03). The time span between the diagnosis of hepatitis B and D was 4.8 +/- 7 years (p < 0.0001). A sustained virological response to interferon-alfa was achieved in 19.5 % of the patients. The yearly incidence rates for death, HCC and complications were 3.2 %, 2.7 % and 8 % among patients with liver cirrhosis. Estimated survival and complication-free survival during 12 years were 72 % and 45 % in cirrhotic compared to 100 % in non-cirrhotic patients (p < 0.008 and p < 0.0001, respectively).

CONCLUSION:

Hepatitis D in western Germany appears to be on the increase and has a migration background that should be considered in clinical practice. Clinical outcome and response to IFN are as poor as in endemic regions, indicating the need to improve early diagnosis.

• Authors: A Erhardt, M Hoernke, U Heinzel-Pleines, A Sagir, T Göbel, D Häussinger
• Journal: Zeitschrift fur Gastroenterologie (Z Gastroenterol) Vol. 48 Issue 8 Pg. 813-7 (Aug 2010) ISSN: 1439-7803 [Electronic] Germany
• PMID: 20687016 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright Georg Thieme Verlag KG Stuttgart New York.

Topics

• Adolescent
• Adult
• Aged
• Child
• Communicable Diseases, Emerging (mortality)
• Disease Outbreaks (statistics & numerical data)
• Female
• Germany (epidemiology)
• Hepatitis D, Chronic (mortality)
• Humans
• Longitudinal Studies
• Male
• Middle Aged
• Outcome Assessment, Health Care
• Prevalence
• Retrospective Studies
• Student Health Services (statistics & numerical data)
• Survival Analysis
• Survival Rate
• Young Adult