Persistent delta antigenaemia in chronic delta hepatitis and its relation with human immunodeficiency virus infection

Roingeard, Philippe; Dubois, Frédéric; Marcellin, Patrick; Bernuau, Jacques; Bonduelle, Sylvie; Benhamou, Jean‐Pierre; Goudeau, Alain

doi:10.1002/jmv.1890380307

Cited by 20 publications

(13 citation statements)

References 14 publications

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“…Although the definite evidence of T cells controlling HDV infection in humans is inadequate, an observation showed that HDV viremia was highly enhanced in human immunodeficiency virus-infected patients whose circulating CD4 ϩ T cells numbers were greatly reduced. 50 Another recent study revealed that the T-cell response to HDAg is related to the activity of HDV-induced liver disease. 13 These findings support the necessity of T-cell immunity to modulate the disease course of HDV infection.…”

Section: Discussionmentioning

confidence: 99%

DNA-based immunization produces Th1 immune responses to hepatitis delta virus in a mouse model

Huang

Tao

et al. 2000

Hepatology

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Hepatitis delta virus (HDVHepatitis delta virus (HDV) is a defective, single-stranded RNA virus that needs the supply of hepatitis B surface antigen (HBsAg) for its assembly and transmission. 1,2 HDV superinfection is one of the major causes of fulminant hepatitis in Taiwan. 3 Superinfection with HDV often results in chronic hepatitis, and many chronic hepatitis D (CHD) patients progress to cirrhosis. [4][5][6][7] In the past decade, universal hepatitis B virus (HBV) vaccination for the newborn in Taiwan has decreased the HBV carrier rate and the incidence of hepatocellular carcinoma in childhood. 8 Unfortunately, up to 5% of the adult population does not respond to the currently licensed HBV vaccines, and millions of individuals are already chronically HBV-infected. Currently, there is no effective vaccine to protect HBV carriers from HDV superinfection.Many reports have indicated that the immune mechanism plays a significant role in the pathogenesis of both HBV and hepatitis C virus infections, 9,10 but the pathogenic mechanism of HDV infection is still controversial. 11 HDV transgenic mice that expressed both large (L-HDAg) and small hepatitis delta antigen (S-HDAg) in the liver did not develop liver disease, providing evidence that HDV is not directly cytopathic. 12 A recent study showed that patients with inactive HDV infection had a significant T-cell proliferation response to HDV synthetic peptides; conversely, patients with active HDV-related hepatitis showed no significant response. 13 It is thus postulated that the host immune response might determine disease activities after HDV infection. 13 Augmentation of the host' s cellular immune response may represent an ideal way to treat chronic HDV infection.At present, there is no effective therapy for chronic HDV infection. Interferon is the only licensed drug to treat CHD, but a large dosage and a long duration of treatment are needed. 14 Furthermore, interferon is only effective in a minor proportion of CHD patients, and relapses are common after discontinuation. DNA vaccine, or nucleic acid vaccine, by means of direct injection of the vector encoding viral proteins sequence intramuscularly or intradermally, is a newly developed technique. [15][16][17][18] This approach can induce a broad range of immune responses and has been successfully used to provide protective immunity against influenza, herpes simplex, rabies, Simian immunodeficiency virus, human immunodeficiency virus, and lymphocytic choriomeningitis virus (LCMV) in different animal model systems. 15,[19][20][21][22][23][24] In the recent literature, HBV-DNA-based immunization has been shown to induce cellular and humoral immune responses in mice, duck, and woodchuck models. [25][26][27][28][29][30] Hepatitis C virus nucleic acid immunization has also been demonstrated in mice models. 17,31-33 DNA vaccination is currently a promising Abbreviations: HDV, hepatitis delta virus; HBsAg, hepatitis B surface antigen; CHD, chronic hepatitis D; HBV, hepatitis B virus; L-HDAg, large hepatitis delta antig...

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Section: Discussionmentioning

confidence: 99%

DNA-based immunization produces Th1 immune responses to hepatitis delta virus in a mouse model

Huang

Tao

et al. 2000

Hepatology

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“…2,12 The IgG antibody is not protective; it is present in all immunocompetent patients with HDV infection, coexisting with active HDV infection and hepatitis D, and may not be raised in immunocompromised patients who acquire HDV such as patients with AIDS. 15 The IgG antibody is usually short lived in coinfected patients who clear HBV HDV. The exception is drug addicts; in a retrospective analysis of blood from 27 Swedish drug addicts drawn 5 to 13 years after the acute episode of HDV coinfection, 26 were clear-cut positive and one still gave a borderline positive result for anti-HD.…”

Section: Antibodies To Hdv Igg Anti-hdmentioning

confidence: 99%

“…Occasionally, the HDAg can be detected in serum of patients with an impaired immune system who do not raise antibodies, such as patients with acquired immune deficiency syndrome (AIDS) or transplanted patients under pharmacologic immunosuppression. 15,24 HDV RNA…”

Section: Igm Anti-hdmentioning

confidence: 99%

Hepatitis Delta Virus Diagnosis

Olivero

Smedile

2012

Semin Liver Dis

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The first step in the diagnosis of hepatitis delta virus (HDV) infection is testing HBsAg-positive individuals for the antibody to the HD antigen (anti-HD).In anti-HD-positive patients, the next step is testing for HDV RNA in serum to determine whether the antibody reflects an ongoing active HDV infection (HDV-RNA-positive) or represents a serologic scar to past HDV infection (HDV-RNA-negative). In the HDV-positive individual with liver disease, it is critical to distinguish acute HDV/hepatitis B virus (HBV) coinfection from chronic HDV superinfection in HBsAg carriers; the course, prognosis, and management of the two conditions are different. The differential diagnosis can be achieved through the scrutiny of the battery of HDV and HBV markers, which combine in patterns characteristic for each condition.Standardized competitive and μ-capture commercial assays are available to determine the IgG and IgM antibody to HDV. Several in-house assays were developed to determine HDV RNA in serum; the sensitivity threshold of current polymerase chain reaction-based assays is 10 copies of HDV RNA/mL. Unfortunately, HDV-RNA assays are not yet standardized and the results from different laboratories often are not comparable due to different sensitivities. The development of an international reference HDV-RNA standard remains an unmet diagnostic need.

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“…Other methodologies include detection of HDV RNA in serum by direct nucleic acid hybridization or with reverse transcriptase-polymerase chain reaction (RT-PCR) (40). PCR detection of HDV has shown it to be a potential problem in patients with the human immunodeficiency virus (HIV) (41). Liver biopsies may also be examined by immunofluorescence, immunoperoxidase, or in situ hybridization for the presence of HDV.…”

Section: Hdv Diagnosismentioning

confidence: 99%

Laboratory diagnosis of human hepatitis viruses

McPherson

1994

Clinical Laboratory Analysis

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Conventional serologic methods of antigen or antibody detection are now widely applied for diagnosis of hepatitis viruses A, B, C, and D. Nucleic acid quantitation has become very useful for monitoring response to antiviral therapy in cases of hepatitis B and C. Special confirmatory testing of HCV serologies can be quite specific, but overall serologies for HCV lack sensitivity for early diagnosis. Thus HCV RNA detection may ultimately be the preferred method for HCV diagnosis and for screening blood donors. Unfortunately, HEV diagnosis may rest on the efforts of research laboratories for electron microscopy, Western blot, or nucleic acid detection.

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Persistent delta antigenaemia in chronic delta hepatitis and its relation with human immunodeficiency virus infection

Cited by 20 publications

References 14 publications

DNA-based immunization produces Th1 immune responses to hepatitis delta virus in a mouse model

DNA-based immunization produces Th1 immune responses to hepatitis delta virus in a mouse model

Hepatitis Delta Virus Diagnosis

Laboratory diagnosis of human hepatitis viruses

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