Survival and complications in a cohort of patients with anti-delta positive liver disease presenting in a tertiary referral clinic.

Background/aims: Our aim was to evaluate the clinical outcome and survival of patients with anti-Delta positive liver disease in The Netherlands.

Methods: We evaluated those patients visiting our hospital between 1978 and 1993 with respect to clinical, virological and histological parameters. During the follow-up period the occurrence of complications of the liver disease and survival was determined. Thirty patients with a median age of 34 years (range 21-52) were included.

Results: During an average follow up of 4.8 years, nine patients died. The overall 5-year survival as estimated by Kaplan-Meyer analysis was 71%, which was comparable to hepatitis B cirrhosis patients. However, in the group without active hepatitis B replication (HBeAg-negative) a clear trend towards a worse survival was identified in Delta cirrhosis patients. Complications and deaths occurred exclusively in the patient group with cirrhotic liver disease. The complications (ascites, elevated bilirubin >34 micro mol/l), variceal bleeding and spontaneous bacterial peritonitis) occurred in 52% of the patients with a follow up of more than 6 months (n=27). Fifty-seven percent of those patients died. In our population anti-Delta positive liver disease affects predominantly young patients and is related to advanced liver disease.

Conclusions: In view of the high death rate, liver transplantation should be considered when signs or symptoms of decompensated liver disease occur.