Print E-mail
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: yschen@vghks.gov.tw (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. 



 

Methods:

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. 



 

Results:

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.
 



 

Conclusion:

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