Hepatitis delta virus propagation enabled by hepatitis C virus - scientifically intriguing; but is it relevant to clinical practice?

TY - JOUR

T1 - Hepatitis delta virus propagation enabled by hepatitis C virus - scientifically intriguing; but is it relevant to clinical practice?

AU - Pflüger, Lisa Sophie

AU - Schulze Zur Wiesch, Julian

AU - Polywka, Susanne

AU - Lütgehetmann, Marc

N1 - © 2020 The Authors. Journal of Viral Hepatitis published by John Wiley & Sons Ltd.

PY - 2021/1

Y1 - 2021/1

N2 - In vitro cell culture experiments and animal models have demonstrated that hepatitis delta virus (HDV) can theoretically propagate being enveloped by human pathogenic viruses other than hepatitis B virus (HBV), namely hepatitis C virus (HCV) and dengue virus. However, the clinical relevance of these findings and whether HDV replication occurs in real-world hepatitis B surface antigen (HBsAg)-negative HCV patient cohorts remain unknown. To this aim, we analysed 323 HCV-RNA-positive and HBsAg-negative sera for the presence of HDV-RNA and anti-HDV antibodies (anti-HDV). All 323 (100%) samples were negative for HDV-RNA. Interestingly, 8/316 samples tested positive for anti-HDV. The HBV serology of these eight patients showed a positive result for HBV core antibodies (anti-HBc) indicating a seroconversion of an acute HBV infection in the past. None of the anti-HBc-negative patients were positive for anti-HDV. Our results indicate a distinctly low probability of replicative HDV infection in HCV mono-infected patients in Germany. Current German clinical guidelines rightly recommend performing HDV screening only in HBsAg-positive patients. However, larger studies on this subject should be performed in regions that are endemic for chronic HBV/HDV as well as HCV infections.

AB - In vitro cell culture experiments and animal models have demonstrated that hepatitis delta virus (HDV) can theoretically propagate being enveloped by human pathogenic viruses other than hepatitis B virus (HBV), namely hepatitis C virus (HCV) and dengue virus. However, the clinical relevance of these findings and whether HDV replication occurs in real-world hepatitis B surface antigen (HBsAg)-negative HCV patient cohorts remain unknown. To this aim, we analysed 323 HCV-RNA-positive and HBsAg-negative sera for the presence of HDV-RNA and anti-HDV antibodies (anti-HDV). All 323 (100%) samples were negative for HDV-RNA. Interestingly, 8/316 samples tested positive for anti-HDV. The HBV serology of these eight patients showed a positive result for HBV core antibodies (anti-HBc) indicating a seroconversion of an acute HBV infection in the past. None of the anti-HBc-negative patients were positive for anti-HDV. Our results indicate a distinctly low probability of replicative HDV infection in HCV mono-infected patients in Germany. Current German clinical guidelines rightly recommend performing HDV screening only in HBsAg-positive patients. However, larger studies on this subject should be performed in regions that are endemic for chronic HBV/HDV as well as HCV infections.

U2 - 10.1111/jvh.13385

DO - 10.1111/jvh.13385

M3 - SCORING: Journal article

C2 - 32852870

VL - 28

SP - 213

EP - 216

JO - J VIRAL HEPATITIS

JF - J VIRAL HEPATITIS

SN - 1352-0504

IS - 1

ER -