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Clinical characteristics of the patients with hepatitis B combining hepatitis D infection
1Infectious Disease Center of Southwest Hospital, Third Military Medical University, Chongqing 400038, China.
Insights
Hepatitis D virus (HDV) infection significantly increases the risk and severity of chronic hepatitis, severe hepatitis, and liver cirrhosis in patients with hepatitis B (HB). HDV may also inhibit HBV DNA replication and directly harm liver cells.
Area of Science:
- Hepatology
- Virology
- Infectious Diseases
Background:
- Hepatitis B virus (HBV) infection is a global health concern.
- Hepatitis D virus (HDV) is a unique satellite virus that requires HBV for replication.
- Understanding the interplay between HBV and HDV is crucial for managing coinfections.
Purpose of the Study:
- To investigate the pathogenesis of hepatitis D virus (HDV) infection.
- To analyze the clinical characteristics and outcomes of patients coinfected with HBV and HDV.
- To compare the clinical features and laboratory results of HDV-positive and HDV-negative hepatitis B patients.
Main Methods:
- A comparative analysis of 507 patients with hepatitis B and HDV infection against 213 patients with hepatitis B alone.
- Evaluation of hepatitis types, prognosis, clinical symptoms, and biochemical markers.
- Analysis of hepatitis virus serological markers, including HBsAg, HBeAg, and HDAg.
Main Results:
- HDV coinfection was associated with higher incidence and mortality rates of severe chronic hepatitis, severe hepatitis, and liver cirrhosis.
- HDV-positive patients exhibited increased rates of bleeding, ascites, hepatic coma, and elevated ALT levels.
- HDV infection led to a lower detection rate of HBeAg and a higher expression of HDAg, suggesting inhibition of HBV replication.
Conclusions:
- HDV infection significantly worsens the prognosis of hepatitis B, increasing the risk of severe liver disease.
- HDV may play a direct cytotoxic role in liver damage and disease progression.
- HDV coinfection can suppress HBV replication, impacting viral markers like HBeAg.
Objective:
To explore the pathogenesis of hepatitis D virus by analyzing the clinic characteristics of 507 cases of hepatitis B (HB) with hepatitis D virus (HDV) infection.
Methods:
The occurrence of different types of hepatitis, the prognosis, clinical features, major biochemistry results, and hepatitis virus marks were analyzed in 507 cases of HB with positive HDV and compared with 213 cases of HB with negative HDV.
Results:
The incidence and the mortality of serious chronic hepatitis, severe hepatitis, and liver cirrhosis were all higher in the HB patients with positive HDV than negative one. The incidence of bleeding, ascites, hepat-coma complication, and the level of ALT were higher in HDV-positive patients than in HDV-negative patients (P<0.01 or P<0.05), and the changes of the major biochemistry results were more obvious than the same types of hepatitis B with negative HDV (P<0.01). The detection rate for HBeAg in serum of the patients positive for HDV was obviously lower than that of the patients negative for HDV(P<0.01). In patients with acute hepatitis, severe hepatitis, and liver cirrhosis, the expression of positive HDAg and negative HBeAG was obviously higher than that of positive HDAg and HBeAg (P<0.01 or P<0.05).
Conclusions:
After HDV infection, the incidences and poor prognosis of serious chronic hepatitis, severe hepatitis, and liver cirrhosis increase. HDV infection can inhibit the replication of HBV DNA or HBeAg expression. The effects of direct cytotoxicity of HDV on hepatocytes may play a major pathogenic role in acute hepatitis and in aggravating illness status to severe type.