乙型肝炎合并丁型肝炎98例临床分析

CLINICAL CHARACTERISTICS OF HDV INFECTION IN VARIOUS TYPES OF HEPATITIS B IN 98 PATIENTS

Clinical manifestations of 98 patients with HDV/HBV infections discovered between 1984 to 1989 were reported. The diagnosis was confirmed by serological and/or histopatholo-gical examinations. Results: (1) HDV infection coexisted in various clinical categories of HBV infection. Both clinical manifestations and pathological changes may be mild or severe. (2) Results of anti-HD test may not concur with that of HDAg in both the serum and the liver tissue. A higher detect rate could be obtained by using several methods. HDV antigenemia was often present in chronic and fulminant hepatitis of various types besides acute hepatitis, and antigenemia persisted for a longer period. (3)With a mortality rate of 31% (30/96, excluding HCC), the prognosis of HDV/HBV infections seemed to be poor, but there were some mild cases. This was not completely consistent with the hypothesis that HDV might directly injure the hepatocytes. (4)The relationship between HDV and the occurrence of HCC needs further research. Two patients in this group and another case of CAH with anti-HD positive developed HCC 2 years later. (5)HBs-Ag was undetectable in 15 patients, including 5 of AH, 5 CAH, and 5 FH. In these patients, HBV infection might have terminated so that HBsAg titers were too low to be detected.