Comparison of the histological and serological parameters of patients with hepatitis delta virus in active and inactive hepatitis B virus carriers.

OBJECTIVE To assess the histological and serological parameters of patients with hepatitis delta virus (HDV) in active HBV versus inactive HBV carriers. STUDY DESIGN An observational study. PLACE AND DURATION OF STUDY Medical Unit IV at Liaquat University Hospital, Jamshoro, Sindh, from June 2008 to September 2011. METHODOLOGY This study included 49 consecutive inactive HBV carriers who were HBsAg-positive, HBV DNA-negative, anti-D antibody-positive, and HDV RNA-positive, as well as 277 patients with active HBV who were HBsAg-positive, anti- HDV antibody-positive, HDV RNA-positive, and demonstrated > 20,000 IU/mL HBV DNA and > 2 (ULN) serum glutamic pyruvic transaminase (SGPT). Informed consent was obtained from each patient. Liver biopsies were obtained and the staging of fibrosis was performed according to the METAVIR scoring system. Continuous variables such as age, SGPT, platelet count, and the HBV DNA level were computed as the mean ± standard deviation. Categorical variables such as gender and stage of fibrosis are expressed as percentages. All data were processed using SPSS version 16. RESULTS This study included 49 patients in an inactive HBV group. Fibrosis stage 0 was observed in 37 (75.5%) patients and 12 (24.5%) were stage 1. Among the 277 patients with active disease, fibrosis stage 0 was present in 7 (2.5%) patients, stage 1 in 31 (11.2%) patients, stage 2 in 172 (62.1%) patients, stage 3 in 44 (15.9%) patients and stage 4 in 23 (8.3%) patients. CONCLUSION HDV in active HBV carriers is severe on its initial presentation and requires prompt treatment whereas in inactive HBV carriers demonstrates an indolent course.