Rizzetto M, Verme G, Recchia S, Bonino F, Farci P, Aricò S, Calzia R, Picciotto A, Colombo M, Popper H
Ann Intern Med. 1983 Apr;98(4):437-41. doi: 10.7326/0003-4819-98-4-437.
To assess the characteristics of chronic hepatitis in hepatitis B surface antigen (HBsAg) carriers with intrahepatic delta antigen, the hepatic histologic findings of 137 patients were reviewed; 101 patients were followed for 2 to 6 years. The predominant liver disease was chronic active hepatitis in 93 patients or cirrhosis in 32; minor forms of chronic persistent or lobular hepatitis were seen in 12 patients. Eight of the 26 patients with an initial diagnosis of cirrhosis died during the follow-up period. Cirrhosis developed in 31 of 75 patients (41%) without nodular regeneration seen in the first biopsy specimen; 5 of these patients died. Treatment with prednisone or azathioprine did not induce histologic amelioration of delta hepatitis or prevent cirrhosis. Chronic HBsAg hepatitis with intrahepatic expression of the delta antigen is an active, progressive disease unresponsive to conventional immunosuppressive treatment.
为评估乙肝表面抗原（HBsAg）携带者合并肝内δ抗原时慢性肝炎的特征，回顾了137例患者的肝脏组织学检查结果；101例患者随访了2至6年。主要肝脏疾病为93例慢性活动性肝炎或32例肝硬化；12例患者为慢性持续性或小叶性肝炎等轻度类型。26例初诊为肝硬化的患者中有8例在随访期间死亡。75例患者中有31例（41%）出现肝硬化，首次活检标本中未见结节性再生；其中5例患者死亡。泼尼松或硫唑嘌呤治疗未使δ型肝炎的组织学改善，也未能预防肝硬化。慢性HBsAg肝炎合并肝内δ抗原表达是一种活动性、进行性疾病，对传统免疫抑制治疗无反应。
