Hepatitis B virus concentrations in serum determined by sensitive quantitative assays in patients with established chronic hepatitis delta virus infection

To clarify the correlation between hepatitis B virus (HBV) DNA levels and s erum alanine aminotransferase (ALT) levels in patients with established chr onic hepatitis delta virus (HDV) infection, sensitive HBV quantitative assa ys were used! for the study. Thirty-four consecutive patients with chronic liver disease who were positive for both hepatitis B surface antigen (HBsAg ) and antibody to HDV (anti-HDV), including 19 patients with chronic hepati tis, 8 patients with liver cirrhosis and 7 patients with hepatocellular car cinoma. All were negative for hepatitis Be antigen (HBeAg) and positive for antibody to HBeAg. HBV DNA was detected in 25 (73.5%) of the 34 patients u sing real-time detection PCR, and the HBV DNA levels of these patients were significantly lower compared with kBeAg status and ALT level-matched patie nts with chronic liver disease positive for HBsAg but negative for anti-HDV . There was no correlation between serum HBV DNA and ALT levels among the 3 4 patients with chronic liver disease positive for anti-HDV. Whereas serum ALT levels in anti-HDV-positive HBsAg carriers with HDV RNA were significan tly higher than those without HDV RNA. Liver damage in, patients with estab lished chronic HDV infection may be caused mainly by ongoing HDV infection not by HBV replication. (C) 2001 Wiley-Liss, Inc.