To study the concordance, sensitivity and specificity of HDV-
RNA determination by molecular hybridization, serum
HDAg by immunoblot and anti-HD
IgM by commercial
enzyme immunoassay as compared to intrahepatic
HDAg detection by an immunoperoxidase method, a statistical analysis was applied to the results of serum sample and liver biopsy determinations in 50 patients with
chronic delta hepatitis (38 positive to tissue
HDAg and 12 negative). Of the 38 patients with hepatic
HDAg, HDV-
RNA was found in 31 (82%), serum
HDAg by immunoblot in 27 (71%) and anti-HD
IgM in 33 (87%). Among the 12 patients without hepatic
HDAg, one was found with serum
HDAg using the immunoblot technique, two (17%) had HDV-
RNA, and 7 (58%) had anti-HD
IgM. Serum
HDAg determination by immunoblot was the most specific test, followed by HDV-
RNA analysis. The least specific was the anti-HD
IgM technique. The anti-HD
IgM test was the most sensitive, followed by HDV-
RNA and serum
HDAg. The concordance with intrahepatic
HDAg detection was highest for HDV-
RNA determination, followed by
HDAg in serum. The least degree of concordance was found with anti-HD
IgM determination. These results suggest that the determination of HDV-
RNA by the hybridization method can be of great value for the diagnosis and monitoring of
chronic delta hepatitis.