[The significance of multiple infections with HBV, HCV and HDV in patients with chronic liver diseases].

Serum samples from 127 patients with chronic liver diseases (CLD) were tested for HBV markers, anti-HCV and HDV markers by enzyme-linked immunosorbent assay (ELISA). The serum samples from some patients were detected for HCV-RNA by reverse transcription and polymerase chain reaction (RT-PCR) technique. The results showed that 85.7% of chronic persistent hepatitis (CPH), 71.0% of chronic active hepatitis (CAH) and 73.9% of liver cirrhosis (LC) were caused by HBV infection only. In 127 patients with CLD, 37 (29.1%) were multiple infections with HBV, HCV and HDV. The incidence of patients with chronic severe hepatitis (CSH) was significantly higher in multiple infections than in HBV infection only (P < 0.05). 74.2% of CSH were caused by multiple infections. The average levels of serum bilirubin and prothrombin time in patients with CSH caused by multiple infections were significantly higher than those in patients caused by HBV infection only (P < 0.05). The mortality rate of patients with CSH caused by multiple infections was significantly higher than that of cases by HBV infection only (P < 0.05). Based on our data, it is concluded that multiple infections with HBV, HCV and HDV might be the major factor leading to the aggravation of CLD. The general condition and prognosis of patients with CSH caused by multiple infections were much worse than those of cases caused by HBV infection only. In China, HBV is a major agent of chronic hepatitis and liver cirrhosis.