CHRONIC DELTA-HEPATITIS IN HIV-INFECTED P ATIENTS

Background: Hepatitis Delta virus (HDV) induces severe liver disease i n HBsAg carriers, In regions such as Spain, drug addicts make-up a lar ge part of the HIV-positive population and they are at risk of HDV inf ection. Natural history of chronic hepatitis D is not well known in HI V-infected patients, Methods: We reviewed the clinical charts of 37 pa tients attending our institution from 1989 to 1993, fulfilling the cri teria for chronic hepatitis D, We compared all clinical, epidemiologic al, serological and histological findings between both HIV-positive an d HIV-negative patients, Results: All the following parameters showed significant statistical differences between the both groups: mean ALT levels (175 vs 79 respectively, p < 0.05), previous episodes of hepati c decompensation (37% vs 10%, p < 0.01), the circulating Delta antigen (26% vs 10%, p < 0.05), the presence of HBeAg in serum (41% vs 0%, p < 0.01) and the HCV coinfection (85% vs 20%, p < 0.01), Histological f indings were not significantly different comparing both groups, as chr onic active hepatitis with cirrhosis was the most common diagnosis. Co nclusion: Chronic hepatitis D may present a more severe course in HIV- infected patients, The higher replication of HDV and the presence of H CV coinfection could explain this worst outcome.