丁型肝炎是丁型肝炎病毒(hepatitis D virus HDV)感染引起的肝脏疾病。HDV是一种有缺陷的小RNA病毒,其复制依赖于乙型肝炎病毒(hepatitis B virus HBV)辅助,以乙型肝炎病毒表面抗原(HBsAg)作为其外膜。HBV/HDV重叠感染可加速肝脏疾病进...丁型肝炎是丁型肝炎病毒(hepatitis D virus HDV)感染引起的肝脏疾病。HDV是一种有缺陷的小RNA病毒,其复制依赖于乙型肝炎病毒(hepatitis B virus HBV)辅助,以乙型肝炎病毒表面抗原(HBsAg)作为其外膜。HBV/HDV重叠感染可加速肝脏疾病进展,导致肝硬化、肝功能失代偿、肝细胞癌(hepatocellular carcinoma HCC)以及肝病相关死亡的风险显著增加。目前我国丁型肝炎流行病学筛查资料尚不完善,我国作为乙肝患病率较高的国家,而丁肝患病率严重被低估,本文的目的是阐述丁型肝炎流行病学现状包括起源、基因型、易感人群及临床表现,阐明丁型肝炎流行病学特点及临床症状特点,并提出未来重点关注人群及临床表现的方向。展开更多
AIM： To assess the clinical presentation and genotypes of delta hepatitis in local population. METHODS： In this prospective study, 39 consecutive patients who were positive for HBsAg and hepatitis D virus （HDV） an...AIM： To assess the clinical presentation and genotypes of delta hepatitis in local population. METHODS： In this prospective study, 39 consecutive patients who were positive for HBsAg and hepatitis D virus （HDV） antibody were included. The patients were divided in two groups on the basis of presence or absence of HDV RNA and a comparative study was done. Genotype of HDV was determined in PCR positive patients. RESULTS： Overall there is male dominance, in which 34 patients out of 39 （87.2%） were male. Twenty （51%） patients were from the adjacent areas of three provinces; Sindh, Punjab and Balochistan indicating the higher prevalence of delta hepatitis in this mid region of Pakistan. Patients of all age groups were affected with delta hepatitis （median 31.5 years, range 12-75）. HDV RNA was detectable in 23 patients （59%）. All the HDV strains belonged to genotype I. HBV DNA was detectable only in 3 cases who were also HBeAg and HDV RNA positive. Patients with detectable HDV RNA were younger than patients with undetectable RNA; mean age 29.7±12.8 years vs 36.8±15.2. There were no statistically significant differences in the clinical presentation and routine biochemical profile of patients with detectable or undetectable HDV RNA. Clinical cirrhosis was present in 19 （49%） patients; 12 with detectable RNA and 7 with undetectable HDV RNA （P = 0.748）. Decompensated disease was seen in eight patients; five and three respectively from each group. Four patients with undetectable RNA and two patients with detectable RNA had normal ALT and ultrasound abdomen. CONCLUSION： HDV may infect at any age, usually young adult males. Genotype I is prevalent. With time some of the patients become HDV RNA negative or asymptomatic carrier. Most of the patients have suppressed HBV DNA replication. Significant numbers of patients have cirrhosis.展开更多
文摘丁型肝炎是丁型肝炎病毒(hepatitis D virus HDV)感染引起的肝脏疾病。HDV是一种有缺陷的小RNA病毒,其复制依赖于乙型肝炎病毒(hepatitis B virus HBV)辅助,以乙型肝炎病毒表面抗原(HBsAg)作为其外膜。HBV/HDV重叠感染可加速肝脏疾病进展,导致肝硬化、肝功能失代偿、肝细胞癌(hepatocellular carcinoma HCC)以及肝病相关死亡的风险显著增加。目前我国丁型肝炎流行病学筛查资料尚不完善,我国作为乙肝患病率较高的国家,而丁肝患病率严重被低估,本文的目的是阐述丁型肝炎流行病学现状包括起源、基因型、易感人群及临床表现,阐明丁型肝炎流行病学特点及临床症状特点,并提出未来重点关注人群及临床表现的方向。
文摘AIM： To assess the clinical presentation and genotypes of delta hepatitis in local population. METHODS： In this prospective study, 39 consecutive patients who were positive for HBsAg and hepatitis D virus （HDV） antibody were included. The patients were divided in two groups on the basis of presence or absence of HDV RNA and a comparative study was done. Genotype of HDV was determined in PCR positive patients. RESULTS： Overall there is male dominance, in which 34 patients out of 39 （87.2%） were male. Twenty （51%） patients were from the adjacent areas of three provinces; Sindh, Punjab and Balochistan indicating the higher prevalence of delta hepatitis in this mid region of Pakistan. Patients of all age groups were affected with delta hepatitis （median 31.5 years, range 12-75）. HDV RNA was detectable in 23 patients （59%）. All the HDV strains belonged to genotype I. HBV DNA was detectable only in 3 cases who were also HBeAg and HDV RNA positive. Patients with detectable HDV RNA were younger than patients with undetectable RNA; mean age 29.7±12.8 years vs 36.8±15.2. There were no statistically significant differences in the clinical presentation and routine biochemical profile of patients with detectable or undetectable HDV RNA. Clinical cirrhosis was present in 19 （49%） patients; 12 with detectable RNA and 7 with undetectable HDV RNA （P = 0.748）. Decompensated disease was seen in eight patients; five and three respectively from each group. Four patients with undetectable RNA and two patients with detectable RNA had normal ALT and ultrasound abdomen. CONCLUSION： HDV may infect at any age, usually young adult males. Genotype I is prevalent. With time some of the patients become HDV RNA negative or asymptomatic carrier. Most of the patients have suppressed HBV DNA replication. Significant numbers of patients have cirrhosis.
