Gastroenterology

Gastroenterology

Volume 81, Issue 6, December 1981, Pages 992-997
Gastroenterology

Infection with the Delta (δ) Agent in Chronic HBsAg Carriers

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References (14)

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    Incidence and significance of antibodies to delta antigen in hepatitis B virus infection

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    Epidemiology of HBV-associated delta agent: geographical distribution of anti-delta and prevalence in polytransfused HBsAg carriers

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    Immunofluorescence detection of a new antigen antibody system (δ/anti-δ) associated with hepatitis B virus in liver and in serum of HBsAg carriers

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  • M Rizzetto

    Biology and characterization of the delta agent

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  • Hepatitis B and D

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    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

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    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].

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