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Infection

, Volume 19, Issue 3, pp 155–158 | Cite as

Interaction between HDV and HBV infection in HBsAg-chronic carriers

  • Evangelista Sagnelli
  • F. M. Felaco
  • A. Petruzziello
  • T. Annella
  • G. Pasauale
  • P. Filippini
  • P. Peinetti
  • L. Aprea
  • G. Giusti
  • F. Piccinino
  • M. Rapicetta
  • T. Stroffolini
  • P. Chionne
  • B. Sarrechia
Originalia

Summary

We studied the interaction between HBV and HDV infection in 149 consecutive subjects with HBsAg positive chronic hepatitis and in 22 chronic HBsAg healthy carriers. Liver HBcAg was detected in 52 (30.4%) of the 171 subjects. Of these 52, 35 were HBV-DNA and HBeAg positive, 11 HBV-DNA positive only; two HBeAg positive only and four were negative for both HBeAg and HBV-DNA. None of the 119 HBcAg-negative subjects had detectable HBV-DNA in serum. HD-Ag in hepatocytes was detected in 31 of the 171 subjects (18%); it was detectable in none of the 22 HBsAg healthy carriers, in four of the 56 patients with chronic persistent hepatitis (7.2%), in six of the 24 patients with chronic lobular hepatitis (25%), in 16 of the 40 patients with chronic active hepatitis (40%) and in five of the 29 with cirrhosis (17%). A presence of anti-HD in serum in the absence of liver HD-Ag was found in 54 of the 171 subjects (32%). This condition was observed not only in patients with a progressive disease (37.7% of chronic active hepatitis or cirrhosis and 33% of chronic lobular hepatitis), but also in healthy carriers (36%) and in chronic persistent hepatitis patients (21.4%). Liver HBcAg was detected in 6.4% of the 31 HD-Ag-positive patients, in 12.9% of the 54 HD-Ag-negative/anti-HD positive, but in 50% of the 86 with no marker of HDV infection. HDV appears to inhibit HBV genome and such inhibition may persist even when anti-HD is the only HDV marker detectable.

Keywords

Hepatitis Chronic Active Hepatitis Hepatitis Patient Healthy Carrier Chronic Persistent Hepatitis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Interaktionen zwischen HDV und HBV bei chronischen HBsAg-Trägern

Zusammenfassung

Bei 149 nacheinander eingewiesenen chronischen HBsAg-positiven Patienten mit chronischer Hepatitis und 22 gesunden HBsAg Trägern wurde die Interaktion zwischen der HBV- und HDV-Infektion untersucht. Bei 52 der insgesamt 171 Personen (30,4%) fand sich HBsAg in den Leberzellen. Bei 35 dieser 52 Fälle wurde HBV-DNA und HBeAg nachgewiesen, in 11 Fällen HBV-DNA allein. Bei den 119 HBcAg-negativen Personen waren HBV-DNA in keinem Fall im Serum nachweisbar. Bei 31 der 171 Personen wurden HD-Ag in Hepatozyten entdeckt (18%). Die 22 gesunden HBsAg-Träger waren alle HD-Ag negativ. Von den 56 Patienten mit chronisch persistierender Hepatitis waren vier positiv (7,2%); von den 24 Patienten mit chronischer lobulärer Hepatitis sechs (25%), von den 40 Patienten mit chronisch aktiver Hepatitis 16 (40%) und von den 29 Patienten mit Zirrhose fünf (17%). 54 der 171 Untersuchten (32%) wiesen im Serum anti-HD auf, ohne daß sich HD- Ag in der Leber nachweisen ließ. Dabei handelte es sich nicht nur um Patienten mit progressivem Krankheitsverlauf (37,7% der Patienten mit chronisch aktiver Hepatitis und 33% derer mit chronischer lobulärer Hepatitis) sondern auch um gesunde Träger (36%) und Patienten mit chronisch persistierender Hepatitis (21,4%). Bei 6,4% der 31 HD-Ag positiven Patienten ließ sich HBcAg in der Leber nachweisen; positiv waren auch 12,9% der 54 HD-Ag-Negativ/anti-HD-Positiven und 50% der Personen ohne Marker für eine HDV-Infektion. Offensichtlich hemmt HDV das HBV-Genom; diese Hemmwirkung kann bestehen bleiben, auch wenn anti-HD der einzige nachweisbare Marker für eine durchgemachte HDV-Infektion ist.

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References

  1. 1.
    Purcell, R. H., Satterfield, W. C., Bergmann, K. F., Smedile, A., Ponzetto, A., Gerin, J. L. Experimental Hepatitis Delta Virus infection in the chimpanzee. In:Rizzetto, M., Gerin, J. L., Purcell, R. H. (eds.): The Hepatitis Delta Virus and its infection. Progress in clinical and biological research. Alan R. Liss, New York 1987, pp. 27–36.Google Scholar
  2. 2.
    Rizzetto, M., Verme, G., Recchia, S., Borino, F., Farci, P. Arico, S., Calziz, R., Picciotto, A., Colombo, M. Chronic hepatitis in carriers of HBsAg with intrahepatic expression of the delta antigen. Ann. Intern. Med. 98 (1983) 437–441.Google Scholar
  3. 3.
    Colombo, M., Cambieri, R., Rumi, M. G., Ronchi, G., Del Ninno, E., De Franchis, R. Long-term delta superinfection in HBsAg carriers and its relationship to the course of chronic hepatitis. Gastroenterology 85 (1983) 235–239.Google Scholar
  4. 4.
    Sagnelli, E., Piccinino, F., Pasquale, G., Di Costanzo, M. G., Franzese, R., Peinetti, P. Delta agent infection: an unfavourable event in HBsAg positive chronic hepatitis. Liver 4 (1984) 170–176.Google Scholar
  5. 5.
    Raimondo, G., Craxi, A., Longo, G., Giannuoli, G., Calagipone, M., Aragona, M., Pecozero, G., Squadzito, G., Palgliaro, L. Delta infection in hepatocellular carcinoma positive for Hepatitis B surface antigen. Ann. Intern. Med. 101 (1984) 343–344.Google Scholar
  6. 6.
    Hadziyannis, S. J., Lieberman, H. M., Karvountris, G. G., Shafritz, D. A. Analysis of liver disease, nuclear HBcAg, viral replication and HBV-DNA in liver and serum HBeAg vs. anti-HBe + carriers of HBV. Hepatology 3 (1983) 656–662.Google Scholar
  7. 7.
    Sagnelli, E., Felaco, F. M., Filippini, P., Pasquale, G., Peinetti, P., Buonaguzio, E., Apua, L., Puilla, C., Piccinino, F., Giusti, G. Influence of HDV infection on clinical, biochemical and histological presentation of HBsAg positive chronic hepatitis. Liver 4 (1989) 229–235.Google Scholar
  8. 8.
    Chen, J. P., Chen, D. S., Chen, C. R. Delta infection on asymptomatic carriers of Hepatitis B surface antigen: low prevalence of delta activity and effective suppression of Hepatitis B virus replication. Hepatology 5 (1988) 1121–1124.Google Scholar
  9. 9.
    Smedile, A., Lavarini, C., Farci, P., Azico, S., Marinucci, G., Dentico, P., Giuliani, G., Cargnel, A., Del Vecchio Blanco, C., Rizzetto, M. Epidemiologic patterns of infection with the Hepatitis B virus-associated delta agent in Italy. Am. J. Epidemiol. 117 (1983) 223–229.Google Scholar
  10. 10.
    Mozace, G., Van der Helm, K., Jilg, W., Deinhardt, F. Detection of hepatitis B virus DNA in serum by a rapid filtration hybridization assay. J. Vir. Meth. 12 (1985) 235–242.Google Scholar
  11. 11.
    Trevisan, A., Gudat, F., Busachi, C., Stocklinand, E., Bianchi, L. An improved method for HBcAg demonstration in paraffin-embedded liver tissue. Liver 2 (1982) 331–339.Google Scholar
  12. 12.
    Yates, F. The analysis of contingency tables with groupings based on quantitative characters. Biometrika 35 (1948) 176–181.Google Scholar

Copyright information

© MMV Medizin Verlag GmbH München 1991

Authors and Affiliations

  • Evangelista Sagnelli
    • 1
  • F. M. Felaco
    • 1
  • A. Petruzziello
    • 1
  • T. Annella
    • 1
  • G. Pasauale
    • 1
  • P. Filippini
    • 1
  • P. Peinetti
    • 1
  • L. Aprea
    • 1
  • G. Giusti
    • 1
  • F. Piccinino
    • 2
  • M. Rapicetta
    • 3
  • T. Stroffolini
    • 3
  • P. Chionne
    • 3
  • B. Sarrechia
    • 3
  1. 1.Clinic of Infectious DiseasesUniversity of NaplesNapoli
  2. 2.Clinic of Tropical and Subtropical Diseases, 1st School of MedicineUniversity of NaplesNapoli
  3. 3.Italian National Institute of HealthRomeItaly

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