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Diagnostic value of anti‐hepatitis D virus (HDV) antibodies revisited: A study of total and IgM anti‐HDV compared with detection of HDV‐RNA by polymerase chain reaction
Author(s) -
HUANG YIHSIANG,
WU JAWCHING,
SHENG WENYUNG,
HUO TEHIA,
CHANG FULLYOUNG,
LEE SHOUDONG
Publication year - 1998
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.1998.tb00546.x
Subject(s) - hepatitis d virus , virology , hepatitis d , titer , superinfection , virus , antibody , medicine , hepatitis b virus , immunology , hbsag
A high serum titre (≥ 1000 or ≥ 5000) of total antibody to hepatitis D virus (anti‐HDV) and positive for immunoglobulin (Ig) M anti‐HDV have been used to represent HDV replication, while reverse transcription‐polymerase chain reaction (RT‐PCR) is currently the most sensitive assay for detecting HDV viraemia. The aim of the present study was to re‐evaluate the correlation of total anti‐HDV and IgM anti‐HDV with HDV viraemia based on RT‐PCR and to assess the clinical significance of these markers in acute and chronic HDV superinfection. Chronic HDV infection was defined as positive HDV‐RNA by RT‐PCR for more than 6 months, while total anti‐HDV titre was defined by serial dilution. Of 178 hepatitis B virus (HBV) carrier patients studied, 119 cases had been anti‐HDV positive for more than 6 months. Two‐thirds (79/119) were positive for HDV viraemia by RT‐PCR. Only half the chronic HDV viraemic patients had a high titre (≥ 1000) of total anti‐HDV, and there was only moderate agreement (K = 0.41) between total anti‐HDV titre/IgM anti‐HDV and HDV‐RNA and chronic HDV viraemia. Based on cross‐sectional and longitudinal follow‐up analyses, serum total anti‐HDV titres ≥ 100 appeared to be an excellent cut‐off titre (K = 0.91) in differentiating chronic from acute HDV infection among viraemic patients. In summary, IgM and a high titre total of anti‐HDV are not good markers of HDV viraemia, but an anti‐HDV titre of ≥ 100 appears to be an excellent marker for the differentiation of acute from chronic HDV superinfection.