Wu J C, Lee S D, Govindarajan S, Kung T W, Tsai Y T, Lo K J, Ting L P
Department of Medicine, Veterans General Hospital, Taipei, Taiwan, Republic of China.
J Infect Dis. 1990 Jun;161(6):1116-20. doi: 10.1093/infdis/161.6.1116.
Twenty of 22 hepatitis delta virus (HDV)-superinfected chronic hepatitis B carriers who had detectable HDV RNA at the acute stage progressed to chronicity, while only 6 of 16 patients without HDV RNA did so (P less than .005). The poor outcome of patients with persistently positive or fluctuating HDV RNA has been indicated by the following findings: 24 of 38 patients suffered from prolonged hepatic inflammation complicated by three to eight episodes of exacerbations; among them, 5 developed cirrhosis and 2 died in a follow-up period of 4 years. For most patients, the replication of HBV was suppressed at acute stage; only 3 of the 38 cases had detectable HBV DNA in sera. While reactivation of HBV was found in another 8 patients in the follow-up period, for 5 it was in the presence of serum HDV RNA and 2 developed cirrhosis. Therefore, serial assays of serum HDV RNA and HBV DNA appeared to be of value in monitoring the clinical course and outcome of acute HDV superinfection and in the study of the long-term interactions between these two viruses.
22例丁型肝炎病毒（HDV）重叠感染的慢性乙型肝炎携带者中，20例在急性期可检测到HDV RNA，这些患者进展为慢性感染，而16例未检测到HDV RNA的患者中只有6例进展为慢性感染（P<0.005）。HDV RNA持续阳性或波动的患者预后较差，以下结果表明了这一点：38例患者中有24例出现长期肝脏炎症，并伴有3至8次病情加重；其中5例发展为肝硬化，2例在4年的随访期内死亡。对于大多数患者，急性期HBV复制受到抑制；38例病例中只有3例血清中可检测到HBV DNA。虽然在随访期内另外8例患者出现了HBV再激活，但其中5例是在血清HDV RNA存在的情况下出现的，2例发展为肝硬化。因此，血清HDV RNA和HBV DNA的系列检测似乎在监测急性HDV重叠感染的临床病程和结局以及研究这两种病毒的长期相互作用方面具有价值。
