Epidemiological, clinical and histological characteristics of HBV/HDV co-infection: a retrospective cross-sectional study in Guangdong, China.

Abstract

BACKGROUND:

The epidemiology of hepatitis D virus (HDV) in China is fairly unknown. The mechanisms whereby HDV leads to accelerated liver disease in hepatitis B virus (HBV)/HDV co-infected patients and the histological characteristics of chronic hepatitis D (CHD) patients need further investigation.

METHODS:

The prevalence of HDV was retrospectively evaluated in all consecutive hospitalized patients with chronic HBV infection from May 2005 to October 2011. HBV/HDV co-infected patients and HBV mono-infected patients were compared clinically and histologically. Significant histological abnormality was defined as significant necroinflammation (grade ≥A2) and/or significant fibrosis (stage ≥ F2).

RESULTS:

6.5% of patients (426/6604) tested positive for IgM anti-HDV. HDV was more common in patients over 50 years old than those under 50 (11.7% vs. 5.1%, P<0.001). HBV/HDV co-infected patients had higher frequencies of end-stage liver disease (ESLD) than HBV mono-infected patients, and HDV co-infection was an independent risk factor for ESLD (OR: 1.428, 95%CI: 1.116-1.827; P = 0.005). The HBV DNA levels in the HBV/HDV group were significantly lower than the HBV group in chronic hepatitis patients (median: 6.50 log10copies/mL vs 6.80 log10copies/mL, P = 0.003), but higher than the HBV group in ESLD patients (median: 5.73 log10copies/mL vs 5.16 log10copies/mL, P<0.001). When stratified by alanine aminotransferase (ALT) level, 46.7%, 56.5% and 80.5% of CHD patients had significant necroinflammation and 86.7%, 87.0% and 90.3% had significant fibrosis with ALT 1-2×upper limit normal (ULN), 2-5×ULN and>5×ULN respectively.

CONCLUSION:

The prevalence of HDV is not low in patients with chronic HBV infection. HDV may contribute to progression to ESLD through late-phase HBV DNA reactivation.

• Authors: Baolin Liao, Fuchun Zhang, Siwei Lin, Haolan He, Yu Liu, Jiansheng Zhang, Ying Xu, Junqing Yi, Yunqing Chen, Huiyuan Liu, Zhanhui Wang, Weiping Cai
• Journal: PloS one (PLoS One) Vol. 9 Issue 12 Pg. e115888 ( 2014) ISSN: 1932-6203 [Electronic] United States
• PMID: 25532128 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• DNA, Viral
• Hepatitis Antibodies

Topics

• Adult
• Aged
• China (epidemiology)
• Coinfection (epidemiology)
• Cross-Sectional Studies
• DNA, Viral (genetics)
• Female
• Follow-Up Studies
• Hepatitis Antibodies (blood)
• Hepatitis B (epidemiology, virology)
• Hepatitis B virus (genetics, isolation & purification)
• Hepatitis D (epidemiology, virology)
• Hepatitis Delta Virus (genetics, isolation & purification)
• Humans
• Liver Function Tests
• Male
• Middle Aged
• Prevalence
• Prognosis
• Retrospective Studies
• Viral Load
• Young Adult