Infection with the Delta (δ) Agent in Chronic HBsAg Carriers
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The hepatitis delta virus: Replication and pathogenesis
2016, Journal of HepatologyCitation Excerpt :In patients who are chronically infected with HBV, superinfection with HDV progresses to chronic HDV infection in the vast majority of patients [125]. Once chronic HDV infection is established, preexisting liver disease worsens, even though HBV replication is typically, but not invariably, suppressed [126–128]. Chronic hepatitis D is characterized by inflammatory infiltrate and progressive deposition of fibrosis, leading to cirrhosis through a typical wound-healing process, as in other chronic viral hepatitis.
Hepatitis B and D
2015, Medicine (United Kingdom)Citation Excerpt :Superinfection by HDV of an individual chronically infected with HBV leads to severe acute hepatitis, which progresses to chronicity in up to 80% of patients.12 Once chronic HDV infection is established, it usually exacerbates the pre-existing liver disease due to HBV.13 However, HBV replication is usually suppressed to low levels during the acute phase of HDV infection and this suppression persists in chronic HDV/HBV infection.14
Clinical and virological characteristics associated with severe acute hepatitis B
2014, Clinical Microbiology and InfectionCitation Excerpt :These data are similar to those reported in our previous study on a similar setting of patients, two-thirds of whom became HCV-RNA positive during a 4- to 6-year follow up and one-third of whom eradicated HCV chronic infection [15], HCV clearance being significantly more frequent in patients with severe AVH-B. Several other models of superinfection or co-infection of the human hepatitis viruses have been described: HCV superinfection inhibits HBV replication in patients with HBV chronic infection [23,24]; HAV superinfection impairs both HBV and HCV replication in patients with a pre-existing HBV or HCV chronic infection, respectively [25]; HDV superinfection exerts a strong suppression of HBV chronic replication [26], and a reciprocal viral inhibition has been described in HBV/HCV concurrent acute infection, a model of co-infection frequently characterized by the clearance of HBV and the progression to chronicity of HCV infection [27]. Also HBV/HCV or HBV/HDV/HCV chronic co-infections are characterized by a reciprocal inhibition of viral replication and by a more severe clinical presentation compared with HBV or HCV chronic mono-infection [28].
Hepatitis B virus infection: Co-infection with hepatitis C virus, hepatitis D virus, and human immunodeficiency virus
2004, Clinics in Liver Disease