[Prevalence of seronegative hepatitis D among patients with chronic viral hepatitis B].

AIM

Evaluate prevalence of hepatitis D virus replication markers among patients with chronic viral hepatitis B (CVHB) with active infection course and pronounced biochemical markers of liver damage (ALT level increase).

MATERIALS AND METHODS

ALT>2N served as a criteria of active CVHB course. The following parameters were determined: HBsAg, anti-HBcor IgG, anti-HBeAb, anti-HCV IgG, anti-HDV IgG+IgM, HBV DNA, HDV RNA. HCV IgG(+) patients were excluded from the analysis. In total 142 patients were examined.

RESULTS

Antibodies against HDV were detected in 16.2% (n=23) with CVHB, and HDV DNAwas detected in 21.8% of the examined individuals (n=31). The following variants of HDV infection marker combination were detected: HDV IgG(-) HDV RNA(-) - 75.3% (n=107), no HDV infection; HDV IgG(+) HDV RNA(-) - 2.8% (n=4), anamnestic antibodies against HDV; HDV IgG(+) HDV RNA (+) - 13.4% (n=19), active CVHB+D infection; HDV IgG(-) HDV RNA(+) - 8.4% (n=12), seronegative course of CVHB+B.

CONCLUSION

Examination of patients with pronounced cytolytic syndrome but PCR HBV DNA (-) must include not only determination of serologic markers of HDV infection but also HDV replication markers (PCR HDV RNA). Detection ofpatients with seronegative HDVcourse among patients with HVHB (8.4%) persuasively demonstrates the necessityto introduce molecular-biological examination for HDV RNA into CVHB laboratory diagnostics algorithm.