X Gu1, Q Li, Y Wang. 1. Infectious Disease Center of Southwest Hospital, Third Military Medical University, Chongqing 400038, China.
Abstract
OBJECTIVE: To explore the pathogenesis of hepatitis D virus by analyzing the clinic characteristics of 507 cases of hepatitis B (HB) with hepatitis D virus (HDV) infection. METHODS: The occurrence of different types of hepatitis, the prognosis, clinical features, major biochemistry results, and hepatitis virus marks were analyzed in 507 cases of HB with positive HDV and compared with 213 cases of HB with negative HDV. RESULTS: The incidence and the mortality of serious chronic hepatitis, severe hepatitis, and liver cirrhosis were all higher in the HB patients with positive HDV than negative one. The incidence of bleeding, ascites, hepat-coma complication, and the level of ALT were higher in HDV-positive patients than in HDV-negative patients (P<0.01 or P<0.05), and the changes of the major biochemistry results were more obvious than the same types of hepatitis B with negative HDV (P<0.01). The detection rate for HBeAg in serum of the patients positive for HDV was obviously lower than that of the patients negative for HDV(P<0.01). In patients with acute hepatitis, severe hepatitis, and liver cirrhosis, the expression of positive HDAg and negative HBeAG was obviously higher than that of positive HDAg and HBeAg (P<0.01 or P<0.05). CONCLUSIONS: After HDV infection, the incidences and poor prognosis of serious chronic hepatitis, severe hepatitis, and liver cirrhosis increase. HDV infection can inhibit the replication of HBV DNA or HBeAg expression. The effects of direct cytotoxicity of HDV on hepatocytes may play a major pathogenic role in acute hepatitis and in aggravating illness status to severe type.
OBJECTIVE: To explore the pathogenesis of hepatitis D virus by analyzing the clinic characteristics of 507 cases of hepatitis B (HB) with hepatitis D virus (HDV) infection. METHODS: The occurrence of different types of hepatitis, the prognosis, clinical features, major biochemistry results, and hepatitis virus marks were analyzed in 507 cases of HB with positive HDV and compared with 213 cases of HB with negative HDV. RESULTS: The incidence and the mortality of serious chronic hepatitis, severe hepatitis, and liver cirrhosis were all higher in the HB patients with positive HDV than negative one. The incidence of bleeding, ascites, hepat-coma complication, and the level of ALT were higher in HDV-positive patients than in HDV-negative patients (P<0.01 or P<0.05), and the changes of the major biochemistry results were more obvious than the same types of hepatitis B with negative HDV (P<0.01). The detection rate for HBeAg in serum of the patients positive for HDV was obviously lower than that of the patients negative for HDV(P<0.01). In patients with acute hepatitis, severe hepatitis, and liver cirrhosis, the expression of positive HDAg and negative HBeAG was obviously higher than that of positive HDAg and HBeAg (P<0.01 or P<0.05). CONCLUSIONS: After HDV infection, the incidences and poor prognosis of serious chronic hepatitis, severe hepatitis, and liver cirrhosis increase. HDV infection can inhibit the replication of HBV DNA or HBeAg expression. The effects of direct cytotoxicity of HDV on hepatocytes may play a major pathogenic role in acute hepatitis and in aggravating illness status to severe type.