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Chronic HDV/HBV co-infection: predictors of disease stage---a case series of HDV-3 patients. | LitMetric

AI Article Synopsis

  • This study investigates chronic HDV/HBV co-infection in a small group of 64 patients, focusing on those infected with the HDV-3 genotype.
  • Researchers identified three patterns of co-infection based on viral replication dominance and found that higher HDV viral loads correlated with greater liver inflammation and fibrosis.
  • Key factors predicting advanced liver disease included high HDV viral load, older age, and splenomegaly, suggesting that HDV plays a crucial role in liver damage in these patients.

Article 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.

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Source
http://dx.doi.org/10.1016/j.jhep.2014.05.041DOI Listing

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