Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Department of Internal Medicine, Pingtung Hospital, Ministry of Health and Welfare, Pingtung, Taiwan.
J Gastroenterol Hepatol. 2020 Nov;35(11):1886-1892. doi: 10.1111/jgh.15061. Epub 2020 Apr 16.
The serial serologic changes of hepatitis D virus (HDV) infection among chronic hepatitis B virus (HBV) infected patients who received oral nucleotide/nucleoside analogues are elusive.
Serum anti-HDV and HDV RNA among chronic hepatitis B (CHB) patients were tested at the time of initiating anti-HBV therapy and subsequently during the follow-up period.
The seropositive rate of anti-HDV and HDV RNA among 2850 CHB patients, was 2.7% and 0.9%, respectively. Factors associated with anti-HDV seropositivity were platelet counts (odds ratio [OR]/95% confidence intervals [CI]: 0.995/0.992-0.999; P = 0.006), HBV DNA levels (OR/CI: 0.81/0.70-0.94; P = 0.005), and hepatitis B e-antigen (HBeAg) seropositivity (OR/CI: 0.22/0.05-0.95; P = 0.04). The only factor associated with HDV RNA positivity among anti-HDV seropositive patients was age (OR/CI: 0.95/0.90-1.00; P = 0.03). The spontaneous clearance rate of serum anti-HDV antibody was 3.0 per 100 person-years with a median follow-up period of 3.5 years (range 2-12 years), whereas the seroclearance rate of HDV RNA was 4.3 per 100 person-years among anti-HDV seropositive patients after a median follow-up period of 6.0 years (range 2-11 years). A baseline anti-HDV titer < 0.5 cut-off index was the only factor predictive of anti-HDV seroclearance (hazard ratio [HR]/CI: 30.11/3.73-242.85; P = 0.001).
HDV infection was not common among patients treated for HBV in Taiwan. Seroclearance of anti-HDV and HDV RNA did occur over time, albeit the chance is rare.
接受口服核苷酸/核苷类似物治疗的慢性乙型肝炎病毒（HBV）感染者中，丁型肝炎病毒（HDV）感染的血清学连续变化难以捉摸。
在开始抗 HBV 治疗时以及随后的随访期间，检测慢性乙型肝炎（CHB）患者的血清抗 HDV 和 HDV RNA。
在 2850 例 CHB 患者中，抗 HDV 和 HDV RNA 的血清阳性率分别为 2.7%和 0.9%。与抗 HDV 血清阳性相关的因素包括血小板计数（比值比[OR]/95%置信区间[CI]：0.995/0.992-0.999；P=0.006）、HBV DNA 水平（OR/CI：0.81/0.70-0.94；P=0.005）和乙型肝炎 e 抗原（HBeAg）血清阳性（OR/CI：0.22/0.05-0.95；P=0.04）。在抗 HDV 血清阳性患者中，与 HDV RNA 阳性相关的唯一因素是年龄（OR/CI：0.95/0.90-1.00；P=0.03）。血清抗 HDV 抗体的自发清除率为每 100 人年 3.0 例，中位随访时间为 3.5 年（范围 2-12 年），而在中位随访时间为 6.0 年（范围 2-11 年）的抗 HDV 血清阳性患者中，HDV RNA 的血清清除率为每 100 人年 4.3 例。基线抗 HDV 滴度<0.5 截断指数是抗 HDV 血清学清除的唯一预测因素（风险比[HR]/CI：30.11/3.73-242.85；P=0.001）。
在台湾接受 HBV 治疗的患者中，HDV 感染并不常见。抗 HDV 和 HDV RNA 的血清清除确实随着时间的推移而发生，尽管机会很少。
