الفهرس 
Hepatitis B VirusOnly 14 pages are availabe for public view
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Abstract
The hepatitis D virus (HDV) was detected by Rizzetto among patients with a severe form of HBV infection in the year of 1977. HDV is a deformed and incomplete delta agent RNA virus which is dependent on HBsAg for transmission and replication. Infection by HDV can be caused either as a co-infection in individuals with HBV or as a superinfection in chronic HBV carriers. Individuals having HBV-HDV co-infection may have more severe acute disease and higher risk of fulminant hepatitis.
This study aimed to detect the prevalence of HDV infection among chronic hepatitis B virus patients and study the criteria of HDV infection among chronic hepatitis B virus patients in comparison to patients with chronic hepatitis B mono-infection.
This study was conducted on 700 consecutive patients with chronic HBV infection and they were recruited from the outpatient virology clinic of Clinical Hepatology Department, National Liver Institute, Menoufiya University and ElMahalla Educational Liver Hospital.
All studied patients were subjected to the following:
Full history taking Detailed physical examination, Laboratory investigations:
Liver functions tests ALT and AST, albumin, total bilirubin and INR. Complete blood count. Kidney functions tests: urea and creatinin.
Summary
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Abdominal ultrasonography. Other Serological testing:
HBsAg and HCV Ab by 3rd generation ELISA Detection of HBV DNA was performed by transcriptase PCR amplification (Real time PCR with lower detection limit 15 IU/ml). Autoimmune markers (ANA,ASMA and AMA) and HIV Ab test. The presence of IgM antibodies to HDV was determined by commercially available ELISA Kits.
Our results can be summarized as follows:
66.7% of the studied patients were male. Patients aged between 16-81 years old. Patients with combined co-infection represented 4.6% of the studied patients. Patients with combined co-infection were almost HBeAg negative (96.6%). As regards values of laboratory investigations, patients with combined co-infection showed higher levels of serum ALT, AST and bilirubin, and lower albumin levels. As regards complete blood count, co-infected patients showed less platelet levels and higher INR levels. 27% of the studied patients were cirrhotic. Almost two thirds of patients with combined co-infection were cirrhotic.
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Conclusion
1. This study provided much needed epidemiological data on the
current state of HDV infection in Egypt. There is a need for better
HBV vaccination coverage and measures to prevent super-infection
with HDV in patients infected with HBV.
2. Safe supply of blood is essential for patients requiring transfusion.
Therefore further efforts to improve the screening tests and to
include screening of delta markers.
3. Proper vaccination and health education programs should be
implemented to prevent this HBV- HDV co-infection.
4. There is decrease in HDV prevalence internationally which may be
due to worldwide HBV vaccination and treatment.
5. This study was limited by its retrospective nature and by the fact that
HDV testing was not available for the entire population of chronic
hepatitis B. Our analysis would have been stronger if HDV RNA
could have been tested in a high percentage of the HDV seropositive
patients.
6. Delta hepatitis is not a vanishing disease and it has a grave prognosis
due to development of early cirrhosis.
7. HDV remains a major health problem in Egypt .Although possibly
reduced in recent years, individuals infected with HBV and HDV are under risk to develop more severe hepatic complications.