Analysis of Virological, Histological and Clinical Features of Hepatitis Delta Virus Infection in Southeastern Turkey

Objectives: The present study aims to investigate biochemical, virological and histological characteristics of hepatitis delta virus infection, which is a serious problem in our region, as well as its relationship with chronic hepatitis B virus (HBV) infection and cirrhosis. Materials and Methods: A total of 220 patients were included in the study. The patients were divided into three groups: group 1 included patients with hepatitis delta virus-related cirrhosis (DA cirrhosis), group 2 consisted of patients with chronic delta hepatitis (CHD) and group 3 composed of patients with chronic hepatitis B (CHB). Biochemical and virological parameters of the patients were analyzed. Patients with CHB and CHD underwent biopsy for histological examination. The results were compared among the three groups. Results: Seventy-five (34.09%) of the patients were women, 145 (65.90%) were males and their mean age was 38.04 years. There were 44 patients (20%) with delta hepatitis-associated cirrhosis, 86 patients with CHD (39.09%) and 90 patients with CHD (40.9%). HBV DNA level was significantly lower in patients with cirrhosis and chronic delta hepatitis than in patients with CHB (p<0.001) (p<0.001). Histology activity score and fibrosis stage were significantly higher in CHD than in CHB (p<0.001) (p<0.001). A significant correlation was determined between fibrosis stage and hepatitis delta virus RNA in CHD patients. There was also a significant correlation between necroinflammatory score and alanine aminotransferase in CHD (p=0.021). Conclusion: In Turkey, the age of onset of delta hepatitis is low and accordingly, related liver cirrhosis develops at a younger age. HBV DNA levels appear to be suppressed in patients with delta hepatitis as compared to patients with CHB. Histologically severe disease picture is seen in patients with delta hepatitis and delta hepatitis-positive cirrhotic patients.