Clinical profile and parameters of patients infected with HBV and co-infected with HDV in Western Amazon

Abstract

Background Hepatitis Delta represents an even greater risk in the progression of advanced liver disease compared with HBV and is related to rapid progression to liver cirrhosis and HCC. The exact mechanism that determines the spontaneous clearance of delta virus or its progression to fibrosis and cirrhosis remains unknown. In this scenario, studies on the influence of virological, immunological and genetic aspects related to clinical evolution in chronic carriers of HBV and HDV are still scarce, especially in the Amazon region. Therefore, this study aimed to analyze the clinical profile of infected and co-infected individuals in the Western Amazon. Methods The study was carried out at the Specialized Outpatient Clinic for Viral Hepatitis belonging to the Centro de Pesquisa em Medicina Tropical de Rondônia/CEPEM. 100 individuals were included, stratified into two groups: 50 with hepatitis B virus and 50 co-infected with hepatitis Delta virus. Results The overall mean age was 48 ± 10.38 years. For the HBV-positive and HDV-positive groups, 66% (33/50) and 54% (27/50) were men and 56% (28/50) and 58% (29/50) were on antiviral treatment, respectively. Among the HBV immune-active carriers, there was a predominance of men, high levels of HBV-DNA, thrombocytopenia and high levels of ALT and AST. HDV carriers with detectable HDV-RNA demonstrated predominance of thrombocytopenia and high levels of ALT and AST. Comparative analysis between patients with HBV and co-infected with HDV shows significant differences in terms of age, HBV viral load levels, platelet levels and albumin levels. Conclusion Thrombocytopenia, hypoalbuminemia, hepatomegaly, splenomegaly and advanced fibrosis were more prevalent in individuals infected with HDV compared to those monoinfected with HBV and may be important markers in differentiating the different infections. Patients with detectable HDV RNA also showed significant changes in biomarkers compared to undetectable patients, suggesting a worse prognostic effect in this group.