Retrospective Analysis of Chronic Hepatitis D in a West...

liver411

Z Gastroenterol. 2010 Aug;48(8):813-817. Epub 2010 Aug 4.

Retrospective Analysis of Chronic Hepatitis D in a West German University
Clinic over Two Decades: Migratory Pattern, Prevalence and Clinical Outcome.

Erhardt A, Hoernke M, Heinzel-Pleines U, Sagir A, Göbel T, Häussinger D.

Klinik für Gastroenterologie, Hepatologie und Infektiologie,
Universitätsklinikum der Heinrich-Heine-Universität Düsseldorf.

Abstract
BACKGROUND/AIMS: Epidemiology, clinical features and long term-course of
chronic hepatitis D were addressed in a non-endemic Central European area.
METHODS: Sixty-seven patients with chronic hepatitis D were identified among
1307 HBsAg carriers at the university hospital Düsseldorf during two decades
(1989 - 2008) and followed for a mean of 7 +/- 6 years. Forty-one of these
were treated with IFN-alfa for at least six months. RESULTS: Hepatitis D
prevalence increased from 4.1 to 6.2 % among HBsAg carriers during the two
decades (p < 0.06). Patients originating from the former Soviet Union (32.1
vs. 46.2 %) and Africa (0 vs. 17.9 %) became more frequent whereas the
prevalence of patients from Southern Europe declined (46.5 vs.17.9 % p <
0.03). The time span between the diagnosis of hepatitis B and D was 4.8 +/- 7
years (p < 0.0001). A sustained virological response to interferon-alfa was
achieved in 19.5 % of the patients. The yearly incidence rates for death, HCC
and complications were 3.2 %, 2.7 % and 8 % among patients with liver
cirrhosis. Estimated survival and complication-free survival during 12 years
were 72 % and 45 % in cirrhotic compared to 100 % in non-cirrhotic patients (p
< 0.008 and p < 0.0001, respectively). CONCLUSION: Hepatitis D in western
Germany appears to be on the increase and has a migration background that
should be considered in clinical practice. Clinical outcome and response to
IFN are as poor as in endemic regions, indicating the need to improve early
diagnosis. © Georg Thieme Verlag

KG Stuttgart · New York.
PMID: 20687016



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