Clinical outcome of acute and chronic hepatitis delta over time: a long-term follow-up study

[Guest guest]

http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2893.2010.01324.x/abstract

Clinical outcome of acute and chronic hepatitis delta over time: a long-term

follow-up study

M. Buti1,2, M. Homs1, F. -Frias1,3, G. Funalleras2, R. Jardí1,3, S.

Sauleda1,4, D. Tabernero1, M. Schaper1, R. Esteban1,2

Article first published online: 8 JUN 2010

DOI: 10.1111/j.1365-2893.2010.01324.x

© 2010 Blackwell Publishing Ltd

Issue

Journal of Viral Hepatitis

Volume 18, Issue 6, pages 434–442, June 2011

Summary.  Long-term changes in the frequency and outcome of hepatitis delta

virus (HDV) infection have seldom been analysed. This retrospective,

longitudinal study includes 398 consecutive hepatitis B surface antigen

(HBsAg)-positive patients with anti-HDV antibodies who attended our institution

between 1983 and 2008. At enrolment, 182 patients had acute and 216 chronic

hepatitis. Patients were grouped into two periods. Those who attended between

1983 and 1995 and those between 1996 and 2008. The former group was

significantly younger, mainly intravenous drugs users, and had a greater

incidence of acute HDV and HIV and HCV coinfection. Patients with acute HBV/HDV

coinfection cleared both infections in 90% of cases, while all patients with HDV

superinfection evolved to chronic disease. One hundred and fifty-eight patients

with chronic HDV were followed for a median period of 158 months. Seventy-two

per cent of the patients remained stable, 18% had hepatic decompensation, 3%

developed hepatocellular carcinoma, and 8% cleared HBsAg. Liver-related death

was observed in 13% of patients and mainly occurred in patients from the first

period (P = 0.012). These results indicate an outbreak of HDV at the end of the

1980s and the beginning of the 1990s, with a large number of acute HDV cases

affecting predominately young, male intravenous drug users. Currently, patients

with chronic HDV disease are older, and factors associated with worse prognosis

include the presence of cirrhosis and age at the time of diagnosis.

[Guest guest]

http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2893.2010.01324.x/abstract

Clinical outcome of acute and chronic hepatitis delta over time: a long-term

follow-up study

M. Buti1,2, M. Homs1, F. -Frias1,3, G. Funalleras2, R. Jardí1,3, S.

Sauleda1,4, D. Tabernero1, M. Schaper1, R. Esteban1,2

Article first published online: 8 JUN 2010

DOI: 10.1111/j.1365-2893.2010.01324.x

© 2010 Blackwell Publishing Ltd

Issue

Journal of Viral Hepatitis

Volume 18, Issue 6, pages 434–442, June 2011

Summary.  Long-term changes in the frequency and outcome of hepatitis delta

virus (HDV) infection have seldom been analysed. This retrospective,

longitudinal study includes 398 consecutive hepatitis B surface antigen

(HBsAg)-positive patients with anti-HDV antibodies who attended our institution

between 1983 and 2008. At enrolment, 182 patients had acute and 216 chronic

hepatitis. Patients were grouped into two periods. Those who attended between

1983 and 1995 and those between 1996 and 2008. The former group was

significantly younger, mainly intravenous drugs users, and had a greater

incidence of acute HDV and HIV and HCV coinfection. Patients with acute HBV/HDV

coinfection cleared both infections in 90% of cases, while all patients with HDV

superinfection evolved to chronic disease. One hundred and fifty-eight patients

with chronic HDV were followed for a median period of 158 months. Seventy-two

per cent of the patients remained stable, 18% had hepatic decompensation, 3%

developed hepatocellular carcinoma, and 8% cleared HBsAg. Liver-related death

was observed in 13% of patients and mainly occurred in patients from the first

period (P = 0.012). These results indicate an outbreak of HDV at the end of the

1980s and the beginning of the 1990s, with a large number of acute HDV cases

affecting predominately young, male intravenous drug users. Currently, patients

with chronic HDV disease are older, and factors associated with worse prognosis

include the presence of cirrhosis and age at the time of diagnosis.

[Guest guest]

http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2893.2010.01324.x/abstract

Clinical outcome of acute and chronic hepatitis delta over time: a long-term

follow-up study

M. Buti1,2, M. Homs1, F. -Frias1,3, G. Funalleras2, R. Jardí1,3, S.

Sauleda1,4, D. Tabernero1, M. Schaper1, R. Esteban1,2

Article first published online: 8 JUN 2010

DOI: 10.1111/j.1365-2893.2010.01324.x

© 2010 Blackwell Publishing Ltd

Issue

Journal of Viral Hepatitis

Volume 18, Issue 6, pages 434–442, June 2011

Summary.  Long-term changes in the frequency and outcome of hepatitis delta

virus (HDV) infection have seldom been analysed. This retrospective,

longitudinal study includes 398 consecutive hepatitis B surface antigen

(HBsAg)-positive patients with anti-HDV antibodies who attended our institution

between 1983 and 2008. At enrolment, 182 patients had acute and 216 chronic

hepatitis. Patients were grouped into two periods. Those who attended between

1983 and 1995 and those between 1996 and 2008. The former group was

significantly younger, mainly intravenous drugs users, and had a greater

incidence of acute HDV and HIV and HCV coinfection. Patients with acute HBV/HDV

coinfection cleared both infections in 90% of cases, while all patients with HDV

superinfection evolved to chronic disease. One hundred and fifty-eight patients

with chronic HDV were followed for a median period of 158 months. Seventy-two

per cent of the patients remained stable, 18% had hepatic decompensation, 3%

developed hepatocellular carcinoma, and 8% cleared HBsAg. Liver-related death

was observed in 13% of patients and mainly occurred in patients from the first

period (P = 0.012). These results indicate an outbreak of HDV at the end of the

1980s and the beginning of the 1990s, with a large number of acute HDV cases

affecting predominately young, male intravenous drug users. Currently, patients

with chronic HDV disease are older, and factors associated with worse prognosis

include the presence of cirrhosis and age at the time of diagnosis.

[Guest guest]

http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2893.2010.01324.x/abstract

Clinical outcome of acute and chronic hepatitis delta over time: a long-term

follow-up study

M. Buti1,2, M. Homs1, F. -Frias1,3, G. Funalleras2, R. Jardí1,3, S.

Sauleda1,4, D. Tabernero1, M. Schaper1, R. Esteban1,2

Article first published online: 8 JUN 2010

DOI: 10.1111/j.1365-2893.2010.01324.x

© 2010 Blackwell Publishing Ltd

Issue

Journal of Viral Hepatitis

Volume 18, Issue 6, pages 434–442, June 2011

Summary.  Long-term changes in the frequency and outcome of hepatitis delta

virus (HDV) infection have seldom been analysed. This retrospective,

longitudinal study includes 398 consecutive hepatitis B surface antigen

(HBsAg)-positive patients with anti-HDV antibodies who attended our institution

between 1983 and 2008. At enrolment, 182 patients had acute and 216 chronic

hepatitis. Patients were grouped into two periods. Those who attended between

1983 and 1995 and those between 1996 and 2008. The former group was

significantly younger, mainly intravenous drugs users, and had a greater

incidence of acute HDV and HIV and HCV coinfection. Patients with acute HBV/HDV

coinfection cleared both infections in 90% of cases, while all patients with HDV

superinfection evolved to chronic disease. One hundred and fifty-eight patients

with chronic HDV were followed for a median period of 158 months. Seventy-two

per cent of the patients remained stable, 18% had hepatic decompensation, 3%

developed hepatocellular carcinoma, and 8% cleared HBsAg. Liver-related death

was observed in 13% of patients and mainly occurred in patients from the first

period (P = 0.012). These results indicate an outbreak of HDV at the end of the

1980s and the beginning of the 1990s, with a large number of acute HDV cases

affecting predominately young, male intravenous drug users. Currently, patients

with chronic HDV disease are older, and factors associated with worse prognosis

include the presence of cirrhosis and age at the time of diagnosis.