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HB eAg‐positive hepatitis delta: virological patterns and clinical long‐term outcome
Author(s) -
Heidrich Benjamin,
C. Serrano Beatriz,
Idilman Ramazan,
Kabaçam Gökhan,
Bremer Birgit,
Raupach Regina,
Önder Fatih O.,
Deterding Katja,
Zacher Behrend J.,
Taranta Andrzej,
Bozkaya Hakan,
Zachou Kalliopi,
Tillmann Hans L.,
Bozdayi Abdurrahman M.,
Manns Michael P.,
Yurdaydın Cihan,
Wedemeyer Heiner
Publication year - 2012
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/j.1478-3231.2012.02831.x
Subject(s) - medicine , hepatocellular carcinoma , hepatitis d , gastroenterology , hepatitis d virus , liver transplantation , hepatitis b virus , liver disease , hepatitis b , virus , virology , immunology , transplantation , hbsag
Background and Aims The presence of the hepatitis B virus ( HBV )‐eAg in patients with hepatitis B is associated with higher HBV replication and with an increased risk to develop liver‐related clinical endpoints defined as liver related death, liver transplantation, development of hepatocellular carcinoma and hepatic decompensation. The aim of this study was to investigate the role of HB eAg in patients co‐infected with the hepatitis D virus ( HDV ). Methods We studied virological markers of HBV and HDV infection and as well as biochemical and clinical features of liver disease in a cohort of 534 anti‐ HDV ‐positive patients. In addition, we compared the clinical long‐term outcome of HB eAg‐positive HDV ‐infected patients with HB eAg‐negative control patients matched for age, gender and baseline‐ MELD score. Results HB eAg‐positive hepatitis delta was detected in 71 of 534 patients (13.3%). HB eAg positivity was associated with a higher biochemical disease activity and higher HB sAg levels in HDV co‐infected patients. Sixty one per cent of the HB eAg‐positive HDV ‐infected patients presented with HBV DNA levels below 2000 IU/ml, at least once during follow‐up. Both HB eAg‐positive and ‐negative patients showed a similar severe clinical long‐term course with about half of the patients developing a liver‐related clinical complication after a median follow‐up period of 51 months (range: 9–193 months). Conclusions HBV DNA levels are low in both HB eAg‐negative and HB eAg‐positive patients suggesting suppressive effects of HDV on HBV irrespective of the phase of HBV infection. The clinical long‐term outcome of HB eAg‐positive patients is not different to HB eAg‐negative patients infected with the HDV .