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Quantification of serum markers of hepatitis B ( HBV ) and Delta virus ( HDV ) infections in patients with chronic HDV infection
Author(s) -
Ricco G.,
Popa D. C.,
Cavallone D.,
Iacob S.,
Salvati A.,
Tabacelia D.,
Oliveri F.,
Mascolo G.,
Bonino F.,
Yuan Q.,
Xia N.S.,
Gheorghe L.,
Brunetto M. R.
Publication year - 2018
Publication title -
journal of viral hepatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.329
H-Index - 100
eISSN - 1365-2893
pISSN - 1352-0504
DOI - 10.1111/jvh.12895
Subject(s) - hepatitis d virus , hbsag , hepatitis d , virology , hepatitis b virus , cirrhosis , medicine , genotype , hepatitis b , virus , immunology , biology , gene , biochemistry
Summary The interplay between hepatitis B ( HBV ) and delta ( HDV ) viruses is complex and not always characterized during chronic HDV infection. We assessed the clinical usefulness of new quantitative assays for HBV and HDV serum markers in a retrospective cross‐sectional study. Sera obtained from 122 HDV genotype 1 and HBV genotype D coinfected, anti‐ HIV ‐negative patients (71 males; median age 49.8 [21.7‐66.9] years), recruited consecutively in two geographical areas (Italy 69 patients, Romania 53 patients) with different HBV and HDV epidemiology, were tested for HB sAg, HBV ‐ DNA , HB crAg, total anti‐ HB c, HDV ‐ RNA , IgM and total anti‐ HDV using quantitative assays. Cirrhosis, which showed comparable prevalence in the two cohorts, was diagnosed in 97 of 122 (79.5%) patients. At multivariate analysis, cirrhosis was associated with lower total anti‐ HB c/IgM anti‐ HDV ratio ( OR 0.990, 95% CI 0.981‐0.999, P = .038), whereas disease activity was associated with higher total anti‐ HDV ( OR 10.105, 95% CI 1.671‐61.107, P = .012) and HDV ‐ RNA levels ( OR 2.366, 95% CI 1.456‐3.844, P = .001). HDV ‐ RNA serum levels showed a positive correlation with HBV ‐ DNA (ρ = 0.276, P = .005), HB sAg (ρ = 0.404, P < .001) and HB crAg (ρ = 0.332, P < .001). The combined quantitative profiling of HBV and HDV serum markers identifies specific patterns associated with activity and stage of chronic hepatitis D ( CHD ). HDV pathogenicity depends on the underlying active HBV infection in spite of the inhibition of its replication. HDV ‐ RNA , IgM anti‐ HDV , total anti‐ HDV , total anti‐ HB c, HB sAg and HB crAg serum levels qualify for prospective studies to predict progressive CHD and identify candidates to antiviral therapy.