Clinical and histological features of delta infection in chronic hepatitis B virus carriers.

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Abstract
Consecutive chronic hepatitis B virus (HBV) carriers (106) were studied for the prevalance of .delta. markers in serum and tissue, and the clinical and histological features of those with and without .delta. infection were compared. Twenty (18.9%) patients were positive for anti-.delta. in serum or .delta. antigen in the liver or both. They presented at a younger age (30.3 vs. 38 yr). All of them were symptomatic at the time of biopsy, in contrast to 35% of patients without .delta. infection who were not symptomatic. Those with .delta. infection had higher serum transaminase values and showed more severe liver damage on biopsy: chronic active hepatitis in 45% and cirrhosis in 55%. There was more pronounced disease activity both within the parenchyma and in the portal and periportal zones. The histological diagnosis of the 86 patients without .delta. infection included minimal disease (10%), chronic persistent hepatitis (9%), chronic active hepatitis (62%), and cirrhosis (19%). .delta. Infection in chronic HBV carriers is associated with a more active and progressive liver disease.