FACTORS ASSOCIATED WITH VIREMIA AND ELEVATED TRANSAMINASE LEVELS IN ASYMPTOMATIC HEPATITIS-D VIRUS-INFECTED RISK GROUPS

To detect hepatitis D virus (HDV) RNA in asymptomatic HDV-infected ris k groups, Northern blot hybridization was carried out using a strand-s pecific riboprobe. Univariate and multivariate analyses were carried o ut to evaluate factors associated with HDV viremia and elevated transa minase levels in these subjects. Two (15%) of 13 antibody to HDV (anti -HDV) -positive intravenous drug addicts, 15 (33%) of 45 anti-HDV posi tive prostitutes, and 6 (40%) of 15 anti-HDV positive brothel goers ha d detectable serum HDV RNA, Older age (>31 years old) was negatively a ssociated with HDV RNA(P<.04), while hepatitis B e antigen (HBeAg) was positively associated with it (P<.002) in univariate analysis. Only H BeAg was still significant in multivariate analysis (P<.05). Of the 76 asymptomatic anti-HDV positive case, 28 (37%) had mildly elevated ser um ALT levels and only 5 (7%) had ALT levels more than twice normal (> 80 U/L). HBeAg (P<.05) and HDV RNA (P<.02) were two factors associated with ALT elevation in univariate analysis, and HDV RNA was the only s ignificant factor in multivariate analysis (P<.005). In summary, activ e replication of HBV seemed to be of help for the assembly of HDV and viremia. However, active replication of HDV was associated mostly with mildly elevated ALT levels in these subjects. These cases may represe nt a particular group in the disease spectrum of HDV infection.