Clinical outcome of acute and chronic hepatitis delta over time:

liver411

a long-term follow-up study.

J Viral Hepat. 2010 Jun 8. [Epub ahead of print]

Clinical outcome of acute and chronic hepatitis delta over time: a long-term
follow-up study.

Buti M, Homs M, Rodriguez-Frias F, Funalleras G, Jardí R, Sauleda S,
Tabernero D, Schaper M, Esteban R.

CIBERehd, Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación,
Barcelona, Spain.

Abstract
Summary. Long-term changes in the frequency and outcome of hepatitis delta
virus (HDV) infection have seldom been analysed. This retrospective,
longitudinal study includes 398 consecutive hepatitis B surface antigen
(HBsAg)-positive patients with anti-HDV antibodies who attended our
institution between 1983 and 2008. At enrolment, 182 patients had acute and
216 chronic hepatitis. Patients were grouped into two periods. Those who
attended between 1983 and 1995 and those between 1996 and 2008. The former
group was significantly younger, mainly intravenous drugs users, and had a
greater incidence of acute HDV and HIV and HCV coinfection. Patients with
acute HBV/HDV coinfection cleared both infections in 90% of cases, while all
patients with HDV superinfection evolved to chronic disease. One hundred and
fifty-eight patients with chronic HDV were followed for a median period of 158
months. Seventy-two per cent of the patients remained stable, 18% had hepatic
decompensation, 3% developed hepatocellular carcinoma, and 8% cleared HBsAg.
Liver-related death was observed in 13% of patients and mainly occurred in
patients from the first period (P = 0.012). These results indicate an outbreak
of HDV at the end of the 1980s and the beginning of the 1990s, with a large
number of acute HDV cases affecting predominately young, male intravenous drug
users. Currently, patients with chronic HDV disease are older, and factors
associated with worse prognosis include the presence of cirrhosis and age at
the time of diagnosis.

PMID: 20546496 [PubMed - as supplied by publisher]