We studied 28 patients with
chronic delta hepatitis for the presence of hepatitis delta virus (HDV)
RNA in serum. The hot start polymerase chain reaction (PCR) method, in which the reaction begins at 60-80 degrees C, showed a higher sensitivity than conventional PCR reaction. Additionally, the presence of
hepatitis B (HBV) and C virus (HCV)
infections were determined by PCR. HDV
RNA was detected in 26 patients (93%), HBV
DNA in 22 (79%), and HCV
RNA in only one. Detection of HDV
RNA correlated very well with detection of
hepatitis delta antigen by immunostaining in the liver. In six patients HDV
RNA was detectable despite the absence of HBV
DNA in serum, suggesting that high levels of HBV are not required for HDV replication. Of 29 control patients with
chronic hepatitis B without antibody to HDV, none had detectable HDV
RNA, while all had HBV
DNA in serum. Detection of HDV
RNA with PCR proved highly sensitive and specific, demonstrating that virtually all patients with chronic HDV
infection had ongoing viral replication.