Abstract:The hepatitis by delta virus patients who underwent liver transplantation were predominantly male, coming from the Brazilian Amazon region and with similar liver function to the hepatitis B virus patients. They had a lower incidence of hepatocellular carcinoma, more marked perioperative thrombocytopenia levels and frequent episodes of upper gastrointestinal bleeding. Patients with hepatitis by delta virus had lower mortality and higher survival than patients with hepatitis B virus.
“…Our findings of similar overall posttransplant survival between HDV coinfected and HBV monoinfected patients is comparable to more recent studies performed internationally (see Table 6 for summary of prior studies evaluating transplant outcomes in HDV patients). This is in contrast to multiple earlier studies that have reported increased HBV recurrence in HBV patients and worse outcomes, 30 , 33 with high levels of HBV replication pretransplant being associated with a higher risk of HDV recurrence posttransplant 29 (which is not the case for HDV). With well-defined immunoprophylaxis and nucleoside treatment algorithms, our study demonstrates that in the current era, similar to other recent studies, increased HBV viral recurrence post-LT appears to be no longer contributing, and inferior outcomes are no longer seen.…”
“…Our findings of similar overall posttransplant survival between HDV coinfected and HBV monoinfected patients is comparable to more recent studies performed internationally (see Table 6 for summary of prior studies evaluating transplant outcomes in HDV patients). This is in contrast to multiple earlier studies that have reported increased HBV recurrence in HBV patients and worse outcomes, 30 , 33 with high levels of HBV replication pretransplant being associated with a higher risk of HDV recurrence posttransplant 29 (which is not the case for HDV). With well-defined immunoprophylaxis and nucleoside treatment algorithms, our study demonstrates that in the current era, similar to other recent studies, increased HBV viral recurrence post-LT appears to be no longer contributing, and inferior outcomes are no longer seen.…”
“…HDV is associated with increased risk of liver cirrhosis and advanced liver disease [27]. HBV/HDV co-infection demonstrates lower platelet counts compared with those in HBV mono-infection, regardless of liver disease stage; however, the functional mechanism is still unknown [27][28][29], whereby when altering immune-related genes and immune response, we observed lower integrity of immune response or white blood cells in our study. In addition, patient samples were grouped into non-HDV-IV and HDV-IV groups, where lower HDV loads were observed in the HDV-IV group than the non-HDV-IV group, but few studies have focused on HDV viral loads linked to genotypes.…”
Hepatitis Delta Virus (HDV) is an RNA virus that requires the presence of hepatitis B surface antigen (HBsAg) to propagate into hepatocytes, with Genotype I being more prevalent globally. However, the prevalence of HDV genotypes in Taiwan is unknown. Accordingly, a cohort including 24 chronic HBV patients who received nucleos(t)ides (NUCs) between January 2002 and July 2018 was used to determine HDV genotypes and genotype specific serological association in chronic HBV carriers. HDV-positive genotypes in 18/24 (75%) males and 6/24 (25%) females were identified among chronic HBV patients. Viremia was lower in HDV-IV patients than in patients affected with other HDV genotypes (1.34 log10 copies/mL vs. 3.30 log10 copies/mL; p = 0.009). A logistics regression analysis revealed that HDV-IV was inversely proportional to HDV RNA (odds ratio [OR]/95% confidence intervals [CI]: 0.370/0.164–0.830; p = 0.017). The serologic association study indicated lower levels of creatinine (p = 0.047) and HDV-RNA (p = 0.009) in the HDV-IV group than the non-HDV-IV group but did not indicate any significant differences in the AST, ALT, bilirubin levels or other laboratory test factors. The three genotypes evident in Taiwan were HDV-I (4/24, 16.7%), HDV-II (6/24, 25.0%), and HDV-IV (14/24, 58.3%), and HDV-IV is the predominant HDV genotype in Taiwan. These results anticipate a clear understanding of HDV genotype serological association in chronic HBV carriers.
“…Fewer HDV patients have been transplanted outside Europe 12,13,35,36 ; they were usually included within larger series of HBsAg cirrhotics, and their virological course and clinical data are often incomplete. Rates of HDV and HBsAg recurrence were nevertheless low and survival rates high also in these series.…”
Section: Liver Transplant For Hdv Disease: Evolution and Resultsmentioning
Hepatitis D is caused by the hepatitis D virus (HDV); it is the most severe form of viral hepatitis in humans, running an accelerated course to cirrhosis. There is no efficacious therapy, and liver transplantation provides the only therapeutic option for terminal HDV disease. However, HDV infection is prevalent in poor countries of the world with no access to liver transplant programs; liver grafting has been performed in high-income countries, where the prevalence of the infection has much diminished as a secondary effect of hepatitis B virus vaccination, and the demand for liver transplantation outlives in aging cirrhotics who acquired hepatitis D decades ago. This review describes the evolution of liver transplantation for HDV disease from its inception in 1987 to the present time, with an outlook to its future. It reports the progress in the prophylaxis of HDV reinfections to the success of the current standard of indefinite combination of hepatitis B virus antivirals with immunoglobulins against the hepatitis B surface antigen; however, the unique biology of the virus provides a rationale to reducing costs by limiting the administration of the immunoglobulins against the hepatitis B surface antigen.
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