COMPARATIVE-ANALYSIS OF SEROLOGICAL MARKERS OF CHRONIC DELTA INFECTION - HDV-RNA, SERUM HDAG AND ANTI-HD-IGM

To study the concordance, sensitivity and specificity of HDV-RNA deter mination by molecular hybridization, serum HDAg by immunoblot and anti -HD IgM by commercial enzyme immunoassay as compared to intrahepatic H DAg detection by an immunoperoxidase method, a statistical analysis wa s applied to the results of serum sample and liver biopsy determinatio ns in 50 patients with chronic delta hepatitis (38 positive to tissue HDAg and 12 negative). Of the 38 patients with hepatic HDAg, HDV-RNA w as found in 31 (82%), serum HDAg by immunoblot in 27 (71%) and anti-HD IgM in 33 (87%). Among the 12 patients without hepatic HDAg, one was found with serum HDAg using the immunoblot technique, two (17%) had HD V-RNA, and 7 (58%) had anti-HD IgM. Serum HDAg determination by immuno blot was the most specific test, followed by HDV-RNA analysis. The lea st specific was the anti-HD IgM technique. The anti-HD IgM test was th e most sensitive, followed by KDV-RNA and serum HDAg. The concordance with intrahepatic HDAg detection was highest for HDV-RNA determination , followed by HDAg in serum. The least degree of concordance was found with anti-HD IgM determination. These results suggest that the determ ination of HDV-RNA by the hybridization method can be of great value f or the diagnosis and monitoring of chronic delta hepatitis.