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Volume 48, Number 1, February 2015

Higher rate of hepatitis events in patients with human immunodeficiency virus, hepatitis B, and hepatitis D genotype II infection: A cohort study in a medical center in southern Taiwan 

Chun-Yuan Lee, Hung-Chin Tsai, Susan Shin-Jung Lee, Kuan-Sheng Wu, Cheng-Len Sy, Jui-Kuang Chen, Yao-Shen Chen

Received: November 28, 2012    Revised: May 9, 2013    Accepted: August 5, 2013   


Corresponding author:

* Corresponding author. Section of Infectious Diseases, Department of Medicine, Kaohsiung Veterans General Hospital, 386 Ta-Chung First
Road, Kaohsiung 813, Taiwan.
E-mail address: (Y.-S. Chen). d These authors contributed equall 


Background and purpose: 

The epidemiology and impact of hepatitis δ virus (HDV) on hepatic outcomes and virological and immunological responses to highly active antiretroviral therapy (HAART) in human immunodeficiency virus (HIV) patients coinfected with hepatitis B virus (HBV) in northern Taiwan have been reported. However, the epidemiology and impact of HDV infection in HIV–HBV coinfection patients in southern Taiwan remains uncertain. 



In this cohort study, a total of 64 HIV patients coinfected with HBV were identified between January 1, 2009 and May 30, 2012. The seroprevalence of anti-HDV antibodies, HDV genotyping, clinical manifestations and hepatic outcomes were compared between the patients with and without HDV coinfection, and laboratory examinations and hepatic outcomes were recorded. 



Among the 64 HIV patients coinfected with HBV, seven were seropositive for HDV (10.9%). There were no statistically significant differences in risk factors for acquiring HIV infection. During a median observation period of 27.8 months, the adjusted hazard ratio of HDV and HBV genotype (type B vs. non-type B) on hepatitis flare-ups were 62.132 (p = 0.04) and 0.028 (p = 0.01), respectively. All seven patients had genotype II and were HDV viremic. The phylogenetic tree analysis and clinical history evaluation did not identify any clusters of HDV infection.



HDV infection resulted in higher rate of hepatitis flare-ups, but it did not have a statistical significance on HIV progression and immunological response to HAART. Whether higher rate of HDV viremia has worse impact on the hepatic outcomes requires further investigation. 


Key words:

Hepatitis B, Hepatitis δ virus, Human immunodeficiency virus