Host dependent modulation of hepatitis delta virus replication in chronic delta hepatitis

To determine whether host dependent differences modulated hepatitis delta virus replication in chronic delta hepatitis, we tested HDV RNA in homosexual and intravenous drug abuser populations. Overall, the seroprevalence of HDV RNA in the two groups with matching clinical characteristics was 72% (76/106 patient visits). A trend for greater prevalence of HDV RNA was noted at initial presentation in homosexuals (82%) compared to intravenous drug abusers (60%, P less than 0.05) and this trend appeared to be maintained during two years of sequential follow-up. The seroprevalence of co-appearing IgM and IgG anti-HD antibodies was similar in the two groups of patients. However, in HDV RNA positive homosexuals IgG anti-HD antibody was more prevalent, and additionally, assumed concordance with HDV RNA of 92% although the significance of this observation is unclear. The difference in prevalence of HIV in the two groups did not reach statistical significance. Prospective studies are required to confirm differences in HDV replication in various patient groups and to define underlying mechanisms.