IgA class antibodies to hepatitis delta virus antigen in acute and chronic hepatitis delta virus infections

Authors

  • Dr. Ian G. McFarlane,

    Corresponding author
    1. Institute of Liver Studies, King's College School of Medicine and Dentistry, Bessemer Road, London SE5 9PJ, United Kingdom
    • Institute of Liver Studies, King's College Hospital, Denmark Hill, London SE5 9RS, U.K.
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  • Kanchan Chaggar,

    1. Institute of Liver Studies, King's College School of Medicine and Dentistry, Bessemer Road, London SE5 9PJ, United Kingdom
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  • Susan E. Davies,

    1. Institute of Liver Studies, King's College School of Medicine and Dentistry, Bessemer Road, London SE5 9PJ, United Kingdom
    Current affiliation:
    1. Department of Histopathology, St. Bartholomew's Hospital, West Smithfield, London EC1A 7BE, UK
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  • Heather M. Smith,

    1. Institute of Liver Studies, King's College School of Medicine and Dentistry, Bessemer Road, London SE5 9PJ, United Kingdom
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  • Graeme J. M. Alexander,

    1. Institute of Liver Studies, King's College School of Medicine and Dentistry, Bessemer Road, London SE5 9PJ, United Kingdom
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  • Roger Williams

    1. Institute of Liver Studies, King's College School of Medicine and Dentistry, Bessemer Road, London SE5 9PJ, United Kingdom
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Abstract

Sera from 31 patients with chronic hepatitis delta virus infection and 18 patients with acute hepatitis delta virus infection were examined for IgA class antibodies to this virus using a newly developed enzyme immunoassay. IgA antibody to hepatitis D virus was detected in 21 (67.7%) of 31 patients with chronic delta viral hepatitis, but in only 1 (5.6%) of the 18 patients with acute infection (p < 0.0005). Of the 21 patients with chronic delta hepatitis with IgA antibody to hepatitis D virus, 19 (90.5%) had moderate-to-severe activity on liver biopsy: 18 of the 21 had histological features of chronic active hepatitis and three had chronic lobular hepatitis. In all, 23 patients with chronic delta hepatitis had moderate-to-severe activity, and 19 (82.6%) had IgA antibody to hepatitis D virus. No statistically significant correlations were found between IgA antibody to hepatitis D virus and biochemical markers of liver injury (p > 0.4), or the presence of hepatitis delta virus antigen in liver biopsies (p > 0.2), in the patients with chronic delta hepatitis. The finding that IgA antibody to hepatitis D virus was almost exclusively associated with chronic hepatitis delta virus infection and correlated independently with moderate-to-severe histological activity (with a specificity of 90.5% and a sensitivity of 82.6%) suggests that this antibody might be a useful serological marker of underlying liver damage in chronic delta hepatitis. (HEPATOLOGY 1991;14:980–984.)

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