Department of Internal Medicine, Kangdong Sacred Heart Hospital of Hallym University Medical Center, Seoul, Republic of Korea.
J Med Virol. 2011 Jul;83(7):1172-7. doi: 10.1002/jmv.22095. Epub 2011 May 3.
Hepatitis D virus (HDV) infection can cause severe acute and chronic liver disease in patients infected with hepatitis B virus (HBV). Despite the significant decline in the global HDV infection, it remains a major health concern in some countries. This study aimed to investigate the prevalence and clinical features of HDV co-infection in patients with chronic HBV infection in Korea, where HBV infection is endemic. Nine hundred forty patients [median age, 48 (18-94) years; men, 64.5%] infected chronically with HBV were enrolled consecutively. All patients who were positive for hepatitis B surface antigen (HBsAg) for at least 6 months and were tested for anti-HDV. A portion of the HDV delta antigen was amplified, sequenced, and subjected to molecular and phylogenetic analysis using sera from the patients who were anti-HDV positive. Clinical features and virologic markers were evaluated. Inactive HBsAg carriers, chronic hepatitis B, cirrhosis and hepatocellular carcinoma accounted for 29.5%, 44.7%, 17.9%, and 8.0%, respectively. Only three patients were positive for anti-HDV, corresponding to a 0.32% positive rate. All patients who were positive for anti-HDV were inactive HBsAg carriers. HDV RNA could be amplified by PCR from the sera of two patients. Phylogenetic analysis showed that both carried HDV genotype 1. In conclusion, the prevalence of HDV infection is very low (0.32%) in Korea. All HDVs were genotype 1 and detected in inactive HBsAg carriers. Therefore, HDV co-infection may not have a significant clinical impact in Korean patients with chronic HBV infection.
丁型肝炎病毒（HDV）感染可导致乙型肝炎病毒（HBV）感染者发生严重的急性和慢性肝脏疾病。尽管全球 HDV 感染率显著下降，但在一些国家仍是一个主要的健康问题。本研究旨在调查韩国慢性 HBV 感染患者中 HDV 合并感染的流行率和临床特征，韩国是 HBV 流行区。连续纳入了 940 例[中位年龄 48（18-94）岁；男性占 64.5%]慢性 HBV 感染者。所有 HBsAg 阳性（HBsAg）至少 6 个月且检测抗-HDV 的患者均进行抗-HDV 检测。对抗-HDV 阳性患者的血清进行部分 HDV 德尔塔抗原扩增、测序，并进行分子和系统进化分析。评估临床特征和病毒学标志物。HBsAg 持续阳性的非活动期携带者、慢性乙型肝炎、肝硬化和肝细胞癌分别占 29.5%、44.7%、17.9%和 8.0%。仅 3 例患者抗-HDV 阳性，阳性率为 0.32%。所有抗-HDV 阳性患者均为 HBsAg 持续阳性的非活动期携带者。从 2 例患者的血清中可通过 PCR 扩增 HDV RNA。系统进化分析显示，两者均携带 HDV 基因 1 型。总之，韩国 HDV 感染的流行率非常低（0.32%）。所有 HDV 均为基因 1 型，且均在 HBsAg 持续阳性的非活动期携带者中检出。因此，HDV 合并感染可能对韩国慢性 HBV 感染患者没有显著的临床影响。
