HBeAg-positive hepatitis delta: virological patterns and clinical long-term outcome
Article first published online: 20 JUN 2012
© 2012 John Wiley & Sons A/S
Volume 32, Issue 9, pages 1415–1425, October 2012
How to Cite
Heidrich, B., C. Serrano, B., Idilman, R., Kabaçam, G., Bremer, B., Raupach, R., Önder, F. O., Deterding, K., Zacher, B. J., Taranta, A., Bozkaya, H., Zachou, K., Tillmann, H. L., Bozdayi, A. M., Manns, M. P., Yurdaydın, C. and Wedemeyer, H. (2012), HBeAg-positive hepatitis delta: virological patterns and clinical long-term outcome. Liver International, 32: 1415–1425. doi: 10.1111/j.1478-3231.2012.02831.x
- Issue published online: 3 SEP 2012
- Article first published online: 20 JUN 2012
- Manuscript Accepted: 7 MAY 2012
- Manuscript Received: 30 NOV 2011
- Integrated Research and Treatment Center Transplantation. Grant Number: IFB-Tx/01EO0802
- VIRGIL European Network of Excellence on Antiviral Drug Resistance. Grant Number: LSHM-CT-2004-503359
- Life Sciences, Genomics and Biotechnology for Health
- HBV ;
- HDV ;
- hepatitis delta
Background and Aims
The presence of the hepatitis B virus (HBV)-eAg in patients with hepatitis B is associated with higher HBV replication and with an increased risk to develop liver-related clinical endpoints defined as liver related death, liver transplantation, development of hepatocellular carcinoma and hepatic decompensation. The aim of this study was to investigate the role of HBeAg in patients co-infected with the hepatitis D virus (HDV).
We studied virological markers of HBV and HDV infection and as well as biochemical and clinical features of liver disease in a cohort of 534 anti-HDV-positive patients. In addition, we compared the clinical long-term outcome of HBeAg-positive HDV-infected patients with HBeAg-negative control patients matched for age, gender and baseline-MELD score.
HBeAg-positive hepatitis delta was detected in 71 of 534 patients (13.3%). HBeAg positivity was associated with a higher biochemical disease activity and higher HBsAg levels in HDV co-infected patients. Sixty one per cent of the HBeAg-positive HDV-infected patients presented with HBV DNA levels below 2000 IU/ml, at least once during follow-up. Both HBeAg-positive and -negative patients showed a similar severe clinical long-term course with about half of the patients developing a liver-related clinical complication after a median follow-up period of 51 months (range: 9–193 months).
HBV DNA levels are low in both HBeAg-negative and HBeAg-positive patients suggesting suppressive effects of HDV on HBV irrespective of the phase of HBV infection. The clinical long-term outcome of HBeAg-positive patients is not different to HBeAg-negative patients infected with the HDV.