Lozano J L, Crespo J, de la Cruz F, Casafont F, Lopez-Arias M J, Martín-Ramos L, Pons-Romero F
Gastroenterology and Hepatology Unit, University Hospital Marqués de Valdecilla, Faculty of Medicine, Santander, Spain.
Med Microbiol Immunol. 1994 Jul;183(3):159-67. doi: 10.1007/BF00196050.
To analyze the serological, clinical and histological significance of hepatitis B virus (HBV) replication among a group of patients with chronic delta hepatitis (CDH), we have studied the clinical and the histological activity in 49 patients with CDH. The HBV-DNA was analyzed by dot-blot and polymerase chain reaction (PCR). Concomitant infection with hepatitis C virus (HCV) was analyzed by reverse transcriptase (RT)-PCR, HDV replication by dot-blot, and human immunodeficiency virus (HIV) infection by enzyme-linked immunosorbent assay. The subjects were divided into three groups according to HBV-DNA status: group I: 14 patients HBV-DNA dot-blot positive; group II: 29 patients HBV-DNA positive only by PCR, and group III: 6 patients HBV-DNA negative by dot-blot and PCR. We have found HBV-DNA by dot-blot in 28.5% of patients, and by PCR in 87.7%. Also 22 patients were anti-HCV positive (86.3% had HCV-RNA by RT-PCR). The first group (HBV-DNA dot-blot positive) had significantly higher serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) than those in the second and third groups. Likewise, serum ALT and AST were significantly higher in the second group (HBV-DNA positive by PCR) than in those of the third group. Histological inflammatory activity was significantly higher in the group of patients with HBV-DNA detectable by dot-blot. The prevalence of serum HDV-RNA and IgM anti-HDV were similar in the three groups. These results were similar in the anti-HCV-positive and -negative patients. In conclusion, these data suggest that: (1) persistence of HBV replication is a major determinant of severe liver damage in chronic delta hepatitis, and (2) HCV and HIV infections do not influence the natural history of CDH.
为分析一组慢性丁型肝炎（CDH）患者中乙型肝炎病毒（HBV）复制的血清学、临床及组织学意义，我们研究了49例CDH患者的临床及组织学活性。通过斑点杂交和聚合酶链反应（PCR）分析HBV-DNA。采用逆转录酶（RT）-PCR分析丙型肝炎病毒（HCV）合并感染情况，斑点杂交分析HDV复制情况，酶联免疫吸附试验分析人类免疫缺陷病毒（HIV）感染情况。根据HBV-DNA状态将研究对象分为三组：第一组：14例患者HBV-DNA斑点杂交阳性；第二组：29例患者仅PCR检测HBV-DNA阳性；第三组：6例患者斑点杂交及PCR检测HBV-DNA均为阴性。我们发现28.5%的患者斑点杂交检测到HBV-DNA，87.7%的患者PCR检测到HBV-DNA。此外，22例患者抗-HCV阳性（86.3%的患者RT-PCR检测到HCV-RNA）。第一组（HBV-DNA斑点杂交阳性）血清丙氨酸氨基转移酶（ALT）和天冬氨酸氨基转移酶（AST）显著高于第二组和第三组。同样，第二组（PCR检测HBV-DNA阳性）血清ALT和AST显著高于第三组。斑点杂交可检测到HBV-DNA的患者组组织学炎症活性显著更高。三组血清HDV-RNA及IgM抗-HDV患病率相似。抗-HCV阳性和阴性患者的这些结果相似。总之，这些数据表明：（1）HBV复制的持续存在是慢性丁型肝炎严重肝损伤的主要决定因素；（2）HCV和HIV感染不影响CDH的自然病程。
