A study of hepatitis delta virus infection in patients with acute and chronic liver disease from northern India.

To assess the prevalence of hepatitis delta virus (H delta V) in northern India, 204 adult patients with acute and chronic liver disease who were positive for hepatitis B virus (HBV) markers were screened for anti-H delta V antibody by enzyme-linked immunosorbent assay (ELISA). Anti-H delta V antibodies were positive in 29 (14.2%) patients. The incidence of H delta V infection was higher (21.4%) in patients with chronic liver disease when compared with those with acute viral hepatitis (10.7%) (P < 0.05). H delta V antibodies were positive in 16.6% of patients with fulminant hepatic failure (FHF) and in 25% of cases with hepatocellular carcinoma. Co-infections were significantly higher in acute hepatitis (80%), while superinfections predominated (66.7%) in chronic liver disease (P < 0.05). Our data show that H delta V is endemic in northern India and should be considered a major health problem.