Department of Gastroenterology, Hepatology and Endocrinology, Hanover Medical School, Hanover, Germany.
Liver Int. 2010 Mar;30(3):430-7. doi: 10.1111/j.1478-3231.2009.02140.x. Epub 2009 Oct 16.
Abstract Background: Hepatitis delta virus (HDV) causes severe liver disease.
To investigate the quantitative HDV-RNA, HBsAg and hepatitis B virus (HBV)DNA levels in correlation to histological, biochemical and demographical parameters in patients with chronic HDV infection as similar data in a large series of HDV patients are missing.
Eighty HDV patients were recruited in Germany, Turkey and Greece; quantitative determination of HDV-RNA, HBsAg and HBV-DNA was performed by real-time polymerase chain reaction, the Architect HBsAg assay and Cobas TaqMan HBV test respectively.
All patients were infected with HDV-genotype 1. Thirty-five patients (48%) had significant fibrosis (Ishak 3-4) and 15 (20.5%) had cirrhosis. HDV viraemia ranged from 1.1 x 10(3) to 8.4 x 10(7) copies/ml with 60% of patients showing HDV-RNA levels above 10(5) copies/ml accompanied by low HBV viraemia (<10(5) copies/ml). However, HDV-RNA and HBV-DNA levels showed no direct inverse correlation. HDV-RNA correlated positively with HBsAg and negatively with age. HBsAg correlated negatively with age and positively with histological grading. Only gamma-glutamyltranspeptidase was independently associated with cirrhosis (P=0.032), while no biochemical parameter was associated with grading.
(i) HBsAg levels correlated with HDV viraemia in chronic HDV. (ii) Biochemical parameters did not accurately indicate the stage and grade of liver disease in chronic HDV and thus liver biopsy seems to remain the major tool for the evaluation of delta hepatitis patients.
调查慢性 HDV 感染患者中与组织学、生化学和人口统计学参数相关的定量 HDV-RNA、HBsAg 和乙型肝炎病毒 (HBV)DNA 水平，因为缺少此类患者的大量数据。
在德国、土耳其和希腊招募了 80 名 HDV 患者；通过实时聚合酶链反应、Architect HBsAg 测定和 Cobas TaqMan HBV 试验分别定量测定 HDV-RNA、HBsAg 和 HBV-DNA。
所有患者均感染了 HDV-基因型 1。35 名患者（48%）有显著纤维化（Ishak 3-4），15 名患者（20.5%）有肝硬化。HDV 病毒血症范围为 1.1×10(3)至 8.4×10(7)拷贝/ml，其中 60%的患者 HDV-RNA 水平高于 10(5)拷贝/ml，同时伴有低 HBV 病毒血症(<10(5)拷贝/ml)。然而，HDV-RNA 和 HBV-DNA 水平之间没有直接的反比关系。HDV-RNA 与 HBsAg 呈正相关，与年龄呈负相关。HBsAg 与年龄呈负相关，与组织学分级呈正相关。只有γ-谷氨酰转肽酶与肝硬化独立相关（P=0.032），而没有生化参数与分级相关。
（i）HBsAg 水平与慢性 HDV 中的 HDV 病毒血症相关。（ii）生化参数不能准确地反映慢性 HDV 患者的肝病分期和分级，因此肝活检似乎仍然是评估δ肝炎患者的主要工具。
