HDV infection in liver cirrhosis [KARACIGER SIROZUNDA DELTA INFEKSIYONU]

It has been known that delta virus infection is highly prevalent in patients with chronic HBV infection in Turkey which is at the Mediterranean Sea region where HDV infection is endemic. In this study we aimed to assess the prevalence of HDV infection, in patients with liver cirrhosis by determining the antiHDV antibodies without considering the HBsAg status and to determine the clinical importance of HDV infection in cirrhotic patients. Of 213 patients with liver cirrhosis, 32 were found to be delta antibody positive. Of 127 HBsAg+ patients, 28 had delta antibodies (22%). Four patients were antiD positive with no detectable HBsAg. All the patients denied a history of blood transfusion. Male/female ratio was 7 in the patients with HDV infection, while this ratio was found to be 4 in HBsAg+ cirrhotics (p>0.05). Hepatic encephalopathy appeared to be more frequent in patients with delta infection compared to those with HBV infection (47% vs 35% p>0.05). There was no difference between the antiD+ patients and the HBsAg+ patients with no detectable antiD in respect of age, sex, clinical findings, ALT levels, and Child-Pugh score. Our results indicate that (1) in our region, delta infection is found frequently (22%) in patients with HBsAg+cirrhosis; (2) there is no difference in clinical findings between the cirrhotic patients with and without delta infection; (3) viral antigen titers may be under detectable limits, therefore even if HBsAg is found to be negative, HDV infection should be sought in patients with liver cirrhosis.