Buti M, Jardi R, Allende H, Cotrina M, Rodriguez F, Viladomiu L, Esteban R, Guardia J
Department of Hepatology, Hospital General Universitario Valle Hebrón, Barcelona, Spain.
J Med Virol. 1996 May;49(1):66-9. doi: 10.1002/(SICI)1096-9071(199605)49:1<66::AID-JMV11>3.0.CO;2-0.
Eighty-six patients were followed for 6.5 years to study the epidemiological, virological, and histological course of chronic delta hepatitis and the relationship of this disease with HIV and HCV infection. Patients were classified into four groups according to simultaneous HCV and/or HIV infection: group 1, HDV infection (20 cases); group 2, HDV and HCV infection (11 cases); group 3, HDV and HIV infection (12 cases), and group 4, HDV, HCV, and HIV infection (43 cases). All but 14 patients were asymptomatic at presentation. Liver histology showed chronic active hepatitis in 53 cases and cirrhosis in 19 cases. During followup, 52 patients remained asymptomatic, 34 developed hepatic dysfunction, 28 died, and 1 received a liver transplant. Among the 28 patients who died, 4 had HDV infection; 3 HDV and HCV infection; 3 HDV and HIV infection; and 18 HDV, HCV, and HIV infection. Death was due to liver failure in 16 (57%), AIDS in 10 (36%), and was unrelated to liver disease in 2 (8%) cases. There results demonstrate that chronic delta hepatitis is a severe disease, especially among drug users with HIV and HCV infection. The high morbidity and mortality of chronic delta hepatitis justifies the use of antiviral therapy to modify the natural course of the disease.
86例患者接受了6.5年的随访，以研究慢性丁型肝炎的流行病学、病毒学和组织学病程，以及该疾病与HIV和HCV感染的关系。根据同时存在的HCV和/或HIV感染情况，患者被分为四组：第1组，HDV感染（20例）；第2组，HDV和HCV感染（11例）；第3组，HDV和HIV感染（12例）；第4组，HDV、HCV和HIV感染（43例）。除14例患者外，所有患者就诊时均无症状。肝脏组织学检查显示，53例为慢性活动性肝炎，19例为肝硬化。在随访期间，52例患者仍无症状，34例出现肝功能障碍，28例死亡，1例接受了肝移植。在28例死亡患者中，4例为HDV感染；3例为HDV和HCV感染；3例为HDV和HIV感染；18例为HDV、HCV和HIV感染。16例（57%）死于肝衰竭，10例（36%）死于艾滋病，2例（8%）死亡与肝脏疾病无关。这些结果表明，慢性丁型肝炎是一种严重疾病，尤其是在合并HIV和HCV感染的吸毒者中。慢性丁型肝炎的高发病率和死亡率证明使用抗病毒治疗来改变疾病自然病程是合理的。
