Possible reactivation of hepatitis D with chronic delta antigenaemia by human immunodeficiency virus.

Shattock, A. G.; Finlay, H; Hillary, Irene B.

doi:10.1136/bmj.294.6588.1656

Cited by 17 publications

(7 citation statements)

References 6 publications

(2 reference statements)

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“…Remission of acute B hepatitis has been observed to be less frequent when HBV superimposes HIV infection [Monno et al, 19881. HIV infection may also extend the period of active HBV replication [Krogsgaard et al, 1987;McDonald et al, 19871. In some instances, it may also cause the reappearance of productive HBV and HDV replication in HBV immune subjects [Shattock et al, 1987;Lazizi et al, 1988;Waite et al, 19881. Moreover, previous reports have described mild forms of liver disease in chronic HBsAg-positive AIDS patients [Reichert et al, 1983;Rutsgi et al, 1984;McDonald et al, 19871 and increased rates of HBV replication as detected by serum HBV-DNA levels and HBcAg-positive cells in the liver [McDonald et al;19871. However, the effect of HIV on HBV and HDV activity has been mainly investigated in male homosexuals, who, unlike intravenous drug addicts (IVDA), are known to carry impairments of the immune system which are not related to HIV infection, but equally affect the progression of hepatitis B [Moestrup et al, 19861.…”

mentioning

confidence: 99%

Lack of HBV and HDV replicative activity in HBsAg‐positive intravenous drug addicts with immune deficiency due to HIV

Monno

Angarano

Santantonio

et al. 1991

Journal of Medical Virology

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The effects of HIV infection on HBV and HDV replication and liver damage were evaluated by comparing the findings from 48 anti-HIV-positive HBsAg chronic carriers with those from 22 matched anti-HIV-negative subjects. The state of HBV/HDV infection was also related to the degree of immunodeficiency of the anti-HIV-positive patients. Most patients were intravenous drug addicts (IVDA) (84.2%); male homosexuals represented only a small proportion (7.1%). Serum HBV-DNA was detected more frequently in anti-HIV-negative than in anti-HIV-positive patients (50% vs. 35%) despite evidence of HDV replication in the anti-HIV-negative group (P = 0.02). Seroconversion from ongoing to inactive HBV infection occurred in 45% of anti-HIV-negative patients as well as in 23% of anti-HIV-positive patients (P = ns). The difference in severity of liver damage between the two groups was not statistically significant (P = 0.84). Furthermore, in the anti-HIV-positive subjects, HBV and/or HDV activity was detected in 63% of patients with mild immunodeficiency (CDC groups II and III with a total CD4 count greater than 400/mm3) and also in 75% of ARC-AIDS patients (CDC groups IV A-IV C) (P = ns). Severe hepatic disease occurred in subjects with CD4 counts above or below 400/mm3 (13 vs. 6, respectively). In conclusion, the data do not demonstrate that HBV or HDV infections are modified by HIV. The epidemiological background of the patients investigated and the extensive spread of hepatitis viruses in Italy before the appearance of HIV may account for the lack of relationship between HIV and HBV/HDV infections.

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mentioning

confidence: 99%

Lack of HBV and HDV replicative activity in HBsAg‐positive intravenous drug addicts with immune deficiency due to HIV

Monno

Angarano

Santantonio

et al. 1991

Journal of Medical Virology

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“…The effects of HIV on chronic hepatitis are not well elucidated. A reactivation of HBV-and HDV infection has been found in patients seropositive for anti-HIV without a new inoculation of infectious material [9,30]. Patients, seropositive for anti-HD and anti-HIV, more often showed pathological liver function tests than anti-HD-positive patients without HIV infection [23].…”

Section: Discussionmentioning

confidence: 98%

Correlation of hepatitis B virus, hepatitis D virus and human immunodeficiency virus type I infection markers in hepatitis B surface antigen positive haemophiliacs and patients without haemophilia with clinical and histopathological outcome of hepatitis

et al. 1992

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The hepatitis D virus (HDV) infection plays a major role in severe liver damage caused by hepatitis. To establish the prevalence of HDV infection in haemophilic patients and patients without haemophilia, 87 patients with chronic hepatitis B virus (HBV) infection were examined for serological evidence of delta hepatitis. In addition HBV, HDV and human immunodeficiency virus type 1 (HIV) infection markers were compared to clinical and histopathological outcome of hepatitis. Out of 46 haemophiliacs 30 (65%) were anti-HD-seropositive; 10 out of 30 anti-HD-positive patients (33%) had pathological liver function tests compared to 2 out of 16 anti-HD-negative haemophiliacs (13%). The rate of HIV infection did not differ between the HDV infected and the non-HDV infected individuals with haemophilia (17/27 anti-HD-positive patients versus 12/16 anti-HD-negative patients). Two haemophilic anti-HD-positive patients underwent liver biopsy, in both cases hepatitis D antigen (HDAg) was detected in the biopsies. Only 2 out of 41 patients without haemophilia were anti-HD-positive. Both had pathological liver function tests; chronic active hepatitis and cirrhosis, respectively, were diagnosed and HDAg was found in the liver biopsies. Out of 39 anti-HD-seronegative patients without haemophilia, 26 (67%) were hepatitis B e antigen positive; in the sera of 20 patients (51%) HBV-DNA was demonstrated, but only 6 patients (15%) had pathological liver function tests. In conclusion a high seroprevalence of HDV infection was found in haemophilic patients treated with non-pasteurized commercial clotting factor concentrates. An endemic spreading of HDV infection in patients without haemophilia with chronic HBV infection could not be detected.(ABSTRACT TRUNCATED AT 250 WORDS)

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“…acute serological course and clearance of acute HBV markers and HDAg, reactivated both hepatitis B and hepatitis D a year later, again with delta antigenaemia. This patient was subsequently found to have been positive for antibody to human immunodeficiency virus (HIV) since his original HBV and HDV infection (Shattock et al, 1988).…”

Section: Hdv Markersmentioning

confidence: 99%

“…16 had follow-up serology (Table 3): one had been continuously positive for serum HDAg for over four years with fluctuating IgM anti-HD. He is also anti-HIV positive and is the index case of reactivation of HDV and HBV infection by HIV (Shattock et al. 1987).…”

Section: Duration and Level Of Hdv Markers In Hbsag Carriersmentioning

confidence: 99%

The serology of delta hepatitis and the detection of IgM anti-HD by EIA using serum derived delta antigen

Shattock

Morris

Kinane³

et al. 1989

Journal of Virological Methods

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A sensitive and specific capture assay for IgM antibody to hepatitis D virus (HDV) was developed employing serum-derived delta antigen (HDAg). In a retrospective and prospective study of an outbreak of hepatitis B (HB), 135 hepatitis B surface antigen (HBsAg) positive drug-abusers with acute hepatitis and 18 HBsAg carriers, attending various hospitals and clinics in Dublin, were found to be infected with HDV. Serological follow-up was available from 24 of those with acute hepatitis allowing a comparison of the duration and level of IgM anti-HD with the more commonly used markers, HDAg and anti-delta (anti-HD), and an assessment of the usefulness of each. HDV and HB serology was grossly altered by human immunodeficiency virus (HIV) in two patients, with severe clinical manifestation in one. All 135 patients with HDV co-infection had delta antigenaemia. In co-infections with optimum sampling times, the mean duration of delta antigenaemia was 21 days. IgM anti-HD was always found between HDAg and sero-conversion to anti-delta and was the only 'window' marker present in five cases. The mean duration of IgM anti-HD was four weeks (optimum at 2.8 weeks) and was of moderate or low titre and occurred simultaneously with HDAg in 78%. In HDV-infected HBsAg carriers, high-titre IgM anti-HD (greater than 1/10,000) persisted for the duration of the study and is a useful indicator of chronic HDV infection. IgM anti-HD was not found in 202 random blood donors nor in 205 patients with non-B hepatitis or other disorders.(ABSTRACT TRUNCATED AT 250 WORDS)

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Possible reactivation of hepatitis D with chronic delta antigenaemia by human immunodeficiency virus.

Cited by 17 publications

References 6 publications

Lack of HBV and HDV replicative activity in HBsAg‐positive intravenous drug addicts with immune deficiency due to HIV

Lack of HBV and HDV replicative activity in HBsAg‐positive intravenous drug addicts with immune deficiency due to HIV

Correlation of hepatitis B virus, hepatitis D virus and human immunodeficiency virus type I infection markers in hepatitis B surface antigen positive haemophiliacs and patients without haemophilia with clinical and histopathological outcome of hepatitis

The serology of delta hepatitis and the detection of IgM anti-HD by EIA using serum derived delta antigen

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