Maladies infectieuses cliniques et pratique

Abstrait

Evaluation of Patients with Hepatitis Delta Virus Infection at First Admission in Izmir, Turkey

Deniz Ozkaya *,Esma Yuksel ,Gunnur Mungan

Objective: To present the clinical and laboratory findings of patients with hepatitis D virus (HDV) at first admission to hospital. Design This retrospective study was conducted on patients with HDV infection at a State Hospital in Turkey. Setting Department of Infectious Diseases, Turkish Ministry of Health, Karsiyaka State Hospital, Izmir, Turkey. Subjects Some 35 982 samples were tested between 2004 and 2010; HBsAg-positive samples were subsequently tested for anti-HDV antibodies. Main Outcome Data of patients with anti-HDV seropositivity recorded at first admission. Results Among 1216 detected chronic HBV infections, a total of 26 (2.1%) cases of seropositive anti-HDV were diagnosed. Twelve of the study group were men, 14 were women. The mean age was 43.30 years (range, 24-79 years). Hepatitis B surface antigen (HBsAg) was positive in all patients, and hepatitis B envelope antigen (HBeAg) was negative in 19 (73.1%). HBV DNA levels were above 2000 IU/mL in six (23.1%) patients, whereas it was below 2000 IU/mL in the remainder. The mean alanine aminotransferase (ALT) and alpha-fetoprotein levels were 59.3 IU/mL (range, 21-152 IU/mL) and 1.9 IU/mL (range, 1.1-3.8 IU/mL), respectively. Liver biopsy was performed in 12 (46.2%) patients in the study group. The mean fibrosis score was 1.9 and the mean histologic activity index was 9.1. Conclusion Although HDV super infection has been associated with more severe liver disease and accelerated progression to cirrhosis, moderate fibrotic activity and histologic scores were seen at the first admission at our institution. Therefore, delta virus infection should be considered in patients with mild ALT elevation, even if HBV DNA levels are below 2000 IU/mL.