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    THE BURDEN OF DELTA HEPATITIS PROJECTED USING A MATHEMATICAL MODEL IN A DELTA HEPATITIS ENDEMIC COUNTRY
    (John Wiley & Sons Inc, 2009) Toy, Mehlika; Onder, Fatih Oguz; Idilman, Ramazan; Bozkaya, Hakan; Degertekin, Halil; Yalcin, Kendal; Schalm, Solko W.
    [Abstract Not Available]
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    Quantitative HBsAg and HDV-RNA levels in chronic delta hepatitis
    (Wiley, 2010) Zachou, Kalliopi; Yurdaydin, Cihan; Drebber, Uta; Dalekos, George N.; Erhardt, Andreas; Cakaloglu, Yilmaz; Degertekin, Halil
    Background: Hepatitis delta virus (HDV) causes severe liver disease. Aims: To investigate the quantitative HDV-RNA, HBsAg and hepatitis B virus (HBV)DNA levels in correlation to histological, biochemical and demographical parameters in patients with chronic HDV infection as similar data in a large series of HDV patients are missing. Methods: Eighty HDV patients were recruited in Germany, Turkey and Greece; quantitative determination of HDV-RNA, HBsAg and HBV-DNA was performed by real-time polymerase chain reaction, the Architect HBsAg assay and Cobas TaqMan HBV test respectively. Results: All patients were infected with HDV-genotype 1. Thirty-five patients (48%) had significant fibrosis (Ishak 3-4) and 15 (20.5%) had cirrhosis. HDV viraemia ranged from 1.1 x 10(3) to 8.4 x 10(7) copies/ml with 60% of patients showing HDV-RNA levels above 105 copies/ml accompanied by low HBV viraemia (<10(5) copies/ml). However, HDV-RNA and HBV-DNA levels showed no direct inverse correlation. HDV-RNA correlated positively with HBsAg and negatively with age. HBsAg correlated negatively with age and positively with histological grading. Only gamma-glutamyltranspeptidase was independently associated with cirrhosis (P=0.032), while no biochemical parameter was associated with grading. Conclusions: (i) HBsAg levels correlated with HDV viraemia in chronic HDV. (ii) Biochemical parameters did not accurately indicate the stage and grade of liver disease in chronic HDV and thus liver biopsy seems to remain the major tool for the evaluation of delta hepatitis patients.
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    Seropositivity for delta hepatitis in patients with chronic hepatitis B and liver cirrhosis in Turkey
    (Wiley, 2008) Degertekin, Halil; Yalcin, Kendal; Yakut, Mustafa; Yurdaydin, Cihan
    Background: Recent reports suggest a decline of delta hepatitis (DH) in the West as well as in the Far East. Aim: To study the DH seroepidemiology in Turkey. Methods: Statistical power analysis was utilized based on data available in a recent article using prevalence figure estimates. Binominal distribution was applied in order to assess the number of samples required to estimate the prevalence with a given precision. Results: Out of 62 studies in the original study, 32 were eliminated because of insufficient power. A total of 6734 patients (5231 with chronic hepatitis and 1503 with cirrhosis) were analysed. Anti-HDV seropositivity among patients with chronic hepatitis B (CHB) and hepatitis B-induced cirrhosis was lowest in the west of the country and highest in the southeast (5 vs. 27%, P < 0.0001 and 20 vs. 46%, P < 0.0001) respectively. Compared with data obtained before 1995, after 1995, DH prevalence in patients with CHB and cirrhosis decreased from 29 to 12% (P < 0.0001) and from 38 to 27% (P=0.03) in central and southeast Turkey and from 38 to 20% (P < 0.0001) and from 66 to 46% (P < 0.002) in west and southeast Turkey respectively. Conclusion: Despite the decrease of its prevalence in Turkey, DH remains a significant health problem in parts of the country with low socio-economic level.