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Clinical long-term outcome of hepatitis D compared to hepatitis B monoinfection

Anika Wranke1, Benjamin Heidrich1, Katja Deterding1

  • 1Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany.

Hepatology International
|October 3, 2023
PubMed

Insights

Hepatitis D virus (HDV) infection accelerates cirrhosis progression more than Hepatitis B virus (HBV) monoinfection. However, once cirrhosis is established, it becomes the primary risk factor for liver complications, regardless of HDV presence.

Area of Science:

  • Hepatology
  • Virology
  • Clinical Medicine

Background:

  • Hepatitis D virus (HDV) causes severe chronic viral hepatitis.
  • The role of underlying cirrhosis in disease progression remains unclear.
  • Comparing long-term outcomes of HDV vs. HBV infection is crucial.

Purpose of the Study:

  • To compare the long-term outcomes of HDV infection versus HBV monoinfection.
  • To evaluate the impact of cirrhosis on disease progression in both infections.
  • To identify risk factors for liver-related end points.

Main Methods:

  • Retrospective study of 175 patients with chronic hepatitis D (CHD).
  • Matched cohort of 175 patients with chronic hepatitis B (CHB) monoinfection.
  • Defined liver-related end points including hepatic decompensation, transplantation, HCC, and death.

Main Results:

  • Clinical complications occurred earlier and more frequently in CHD patients.
  • HDV infection was independently associated with a higher risk of end points (HR: 3.0).
  • In cirrhotic patients, no significant difference in end points between HBV and HDV; CHB patients had higher HCC rates.

Conclusions:

  • HDV accelerates cirrhosis progression compared to HBV.
  • Established cirrhosis, not HDV itself, is the dominant risk factor for liver complications and HCC.
  • Cirrhosis is the key determinant of poor outcomes in chronic viral hepatitis.
Abstract

Keywords:
CirrhosisClinical longterm outcomeHBeAgHepatitis BHepatitis deltaHepatocellular carcinomaLiver decompensationNucleos(t)ide analogsPegylated interferon alphaTherapy

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