Wornei Silva Miranda Braga1, Cintia Mara Costa de Oliveira2, José Ribamar de Araújo3, Marcia da Costa Castilho4, Joelma Martins Rocha4, Joao Bosco de Lima Gimaque4, Maria Luana Cristiny Rodrigues Silva4, Heline Lira Vasconcelos4, Rajendranath Ramasawmy5, Raymundo Paraná6. 1. Virology Department, Tropical Medicine Foundation Dr. Heitor Vieira Dourado, Manaus, Amazonas, Brazil. Electronic address: wornei.braga@hotmail.com. 2. Virology Department, Tropical Medicine Foundation Dr. Heitor Vieira Dourado, Manaus, Amazonas, Brazil; Multidisciplinar Center, Federal University of Amazonas, Manaus, Amazonas, Brazil. 3. Anatomopatology Department, Tropical Medicine Foundation Dr. Heitor Vieira Dourado, Manaus, Amazonas, Brazil. 4. Virology Department, Tropical Medicine Foundation Dr. Heitor Vieira Dourado, Manaus, Amazonas, Brazil. 5. Virology Department, Tropical Medicine Foundation Dr. Heitor Vieira Dourado, Manaus, Amazonas, Brazil; Nilton Lins University, Manaus, Amazonas, Brazil. 6. Gastroenterology Unit, Federal University of Bahia, Salvador, Bahia, Brazil.
Abstract
BACKGROUND & AIMS: Chronic HDV/HBV co-infection is perhaps the most intriguing amongst all viral hepatitis. Only few studies focus deeply on this topic, particularly with patients infected with HDV-3. This study aimed to identify predictors of advanced disease, examining a cross-sectional data of 64 patients. METHODS: Histological grading was used to characterize the disease stages and viral loads were tested as predictors of necroinflammatory activity and fibrosis. RESULTS: We identified three HDV/HBV co-infection patterns: patients with predominant HDV replication (56.3%), patients with similar viral loads of both viruses (40.6%), and patients with predominant HBV replication (3.1%). Mean HDV-RNA showed a positive trend regarding inflammatory activity and grade of fibrosis. HDV viral load correlated positively with serum levels of liver enzymes and inversely with platelets count. HBV viral load showed no correlation with any of the above parameters. Advanced fibrosis was associated with age, splenomegaly, and HDV viral load of more than 2 log10. Multiple logistic regression confirmed the independent effect of HDV viral predominance. Advanced necroinflammatory activity was independently associated with HDV viral load and splenomegaly. CONCLUSIONS: HDV may possibly play an important and direct role in the establishment of necroinflammatory activity and fibrosis. Data show an indigenous HDV genotype, HDV-3, similar to those described in the Amazon region.
BACKGROUND & AIMS:Chronic HDV/HBV co-infection is perhaps the most intriguing amongst all viral hepatitis. Only few studies focus deeply on this topic, particularly with patients infected with HDV-3. This study aimed to identify predictors of advanced disease, examining a cross-sectional data of 64 patients. METHODS: Histological grading was used to characterize the disease stages and viral loads were tested as predictors of necroinflammatory activity and fibrosis. RESULTS: We identified three HDV/HBV co-infection patterns: patients with predominant HDV replication (56.3%), patients with similar viral loads of both viruses (40.6%), and patients with predominant HBV replication (3.1%). Mean HDV-RNA showed a positive trend regarding inflammatory activity and grade of fibrosis. HDV viral load correlated positively with serum levels of liver enzymes and inversely with platelets count. HBV viral load showed no correlation with any of the above parameters. Advanced fibrosis was associated with age, splenomegaly, and HDV viral load of more than 2 log10. Multiple logistic regression confirmed the independent effect of HDV viral predominance. Advanced necroinflammatory activity was independently associated with HDV viral load and splenomegaly. CONCLUSIONS: HDV may possibly play an important and direct role in the establishment of necroinflammatory activity and fibrosis. Data show an indigenous HDV genotype, HDV-3, similar to those described in the Amazon region.
Authors: V Takyar; P Surana; D E Kleiner; K Wilkins; J H Hoofnagle; T J Liang; T Heller; C Koh Journal: Aliment Pharmacol Ther Date: 2016-11-04 Impact factor: 8.171
Authors: Rami Zakh; Alexander Churkin; William Bietsch; Menachem Lachiany; Scott J Cotler; Alexander Ploss; Harel Dahari; Danny Barash Journal: Mathematics (Basel) Date: 2021-12-20
Authors: Hugo Perazzo; Antonio G Pacheco; Paula M Luz; Rodolfo Castro; Chris Hyde; Juliana Fittipaldi; Caroline Rigolon; Sandra W Cardoso; Beatriz Grinsztejn; Valdiléa G Veloso Journal: BMC Infect Dis Date: 2017-07-31 Impact factor: 3.090