Huang Y H, Wu J C, Sheng W Y, Huo T I, Chang F Y, Lee S D
Department of Medicine, Veterans General Hospital-Taipei and National Yang-Ming University School of Medicine, Taiwan, Republic of China.
J Gastroenterol Hepatol. 1998 Jan;13(1):57-61. doi: 10.1111/j.1440-1746.1998.tb00546.x.
A high serum titre (> or = 1000 or > or = 5000) of total antibody to hepatitis D virus (anti-HDV) and positive for immunoglobulin (Ig)M anti-HDV have been used to represent HDV replication, while reverse transcription-polymerase chain reaction (RT-PCR) is currently the most sensitive assay for detecting HDV viraemia. The aim of the present study was to re-evaluate the correlation of total anti-HDV and IgM anti-HDV with HDV viraemia based on RT-PCR and to assess the clinical significance of these markers in acute and chronic HDV superinfection. Chronic HDV infection was defined as positive HDV-RNA by RT-PCR for more than 6 months, while total anti-HDV titre was defined by serial dilution. Of 178 hepatitis B virus (HBV) carrier patients studied, 119 cases had been anti-HDV positive for more than 6 months. Two-thirds (79/119) were positive for HDV viraemia by RT-PCR. Only half the chronic HDV viraemic patients had a high titre (> or = 1000) of total anti-HDV, and there was only moderate agreement (kappa = 0.41) between total anti-HDV titre/IgM anti-HDV and HDV-RNA and chronic HDV viraemia. Based on cross-sectional and longitudinal follow-up analyses, serum total anti-HDV titres > or = 100 appeared to be an excellent cut-off titre (kappa = 0.91) in differentiating chronic from acute HDV infection among viraemic patients. In summary, IgM and a high titre total of anti-HDV are not good markers of HDV viraemia, but an anti-HDV titre of > or = 100 appears to be an excellent marker for the differentiation of acute from chronic HDV superinfection.
血清中丁型肝炎病毒（HDV）总抗体高滴度（≥1000或≥5000）且免疫球蛋白（Ig）M抗-HDV呈阳性已被用来代表HDV复制，而逆转录-聚合酶链反应（RT-PCR）是目前检测HDV血症最敏感的检测方法。本研究的目的是基于RT-PCR重新评估总抗-HDV和IgM抗-HDV与HDV血症的相关性，并评估这些标志物在急性和慢性HDV重叠感染中的临床意义。慢性HDV感染定义为RT-PCR检测HDV-RNA阳性超过6个月，而总抗-HDV滴度通过系列稀释确定。在研究的178例乙型肝炎病毒（HBV）携带者患者中，119例抗-HDV阳性超过6个月。三分之二（79/119）的患者RT-PCR检测HDV血症呈阳性。只有一半的慢性HDV血症患者总抗-HDV滴度高（≥1000），总抗-HDV滴度/I gM抗-HDV与HDV-RNA及慢性HDV血症之间只有中度一致性（kappa = 0.41）。基于横断面和纵向随访分析，血清总抗-HDV滴度≥100似乎是区分病毒血症患者急性和慢性HDV感染的极佳临界滴度（kappa = 0.91）。总之，IgM和高滴度的总抗-HDV不是HDV血症的良好标志物，但抗-HDV滴度≥100似乎是区分急性和慢性HDV重叠感染的极佳标志物。
