Produção Nacional
Is Hepatitis Delta Genotype 3 Disease Truly a Different Issue?
2019; RELX Group (Netherlands); Linguagem: Inglês
10.2139/ssrn.3328665
ISSN1556-5068
AutoresWornei Silva Miranda Braga, Alinne Lais Bessa Maia, Marcelo Tapajós Araújo, J. Leão, Luíz Carlos de Lima Ferreira, Lourenço Candido Neves, Felipe Guedes Amorim, Márcia da Costa Castilho, Cíntia Mara Costa de Oliveira,
Tópico(s)Hepatitis C virus research
ResumoBackground: Hepatitis D is a complex interplay between the human host, hepatitis B virus and a defective RNA virus. In South America HDV-3 is the native genotype and is associated with severe clinical outcomes. Methods: A descriptive clinical study was conducted to identify non-invasive predictors of compensated advanced chronic liver disease (cACLD) in HDV/HBV-infected patients. Findings: Twenty-five individuals, predominantly males with a median age of 38 years, were consecutively included. Positivity for HBeAg was 20%. Viral load of HBV-DNA and HDV-RNA was quantifiable in 19 and 13 patients (2.32log10 IU/mL and 5.12log10 IU/mL) respectively. All patients with HDV-RNA positive were grouped as HDV-3 by nucleotide sequencing. Lab tests showed a median ALT of 47U/L, GGT of 52U/I, and mean platelet count of 153,000/mm3. Among patients with imaging tests, splenomegaly was identified in nine and esophageal varices in four. Liver biopsy, performed in 13 patients, showed the following stages: 4 (F0), 3 (F1), 4 (F2), 1 (F3) and 1 (F4). Ten study subjects were classified as cACLD and 15 as chronic hepatitis D. Logistic regression associated cACLD with male gender, elevated GGT, low prothrombin time and platelets count <150,000/mm3. Transient elastography (TE) showed an AUROC of 0.944. Interpretation: Chronic HDV-3 infected subjects possibly differ from those infected with other HDV clade regarding the risk of coagulopathy, and TE showed to be the most accurate non-invasive test, possible to be used in endemic areas where liver biopsy is impracticable. Funding Statement: Tropical Medicine Foundation Dr Heitor Vieira Dourado.Declaration of Interests: The authors declare no competing interests.Ethics Approval Statement: All subjects gave their informed consent for their participation, diagnostic procedures and liver biopsy. This study was approved by the Ethical Board of FMT-HVD/AM, number approved CAAE 55957816.0.0000.0005. N. 1.573.584.
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