Hepatitis delta virus infection in acute hepatitis in Kuwait

Over a period of 1 year, 254 patients presenting with acute hepatitis at the Infectious Disease Hospital, Kuwait were positive for hepatitis B surface antigen (HBsAg). Of these, 23 (9%) patients were found to have antibodies to hepatitis D virus (HDV) (anti-HDV). Eight of these anti-HDV positive patients were shown to have a coinfection with acute hepatitis B and 8 had a superinfection of HDV on a chronic HBsAg infection. The remaining 7 had had a previous HDV infection and were also chronic carriers of HBsAg. The cause of the acute hepatitis in this group was probably non-A, non-B virus(es). The prevalence of anti-HDV was 4% among patients with acute hepatitis B and 31% among carriers of HBsAg. In the coinfection group, 5/8 patients recovered completely, 1 developed chronic active hepatitis and 1 died due to fulminant hepatitis, while 1 patient was lost to follow up. 5/8 patients with superinfection developed chronic hepatitis on follow-up, 2 died while only 1 patient recovered completely. In the group of patients with previous delta infection, 5/7 recovered from the acute bout of hepatitis while 1 patient developed chronic active hepatitis and 1 was lost to follow-up.