Prevalence and significance of intrahepatic hepatitis delta virus antigen expression in HB_eAg-negative patients with chronic type-B hepatitis in Taiwan

A consecutive series of 97 HB_eAg-negative patients with chronic type-B hepatitis, who were not drug addicts or hemophiliacs, were examined for the prevalence of intrahepatic expression of hepatitis delta virus (HDV) antigen (HDAg) by direct immunofluorescence. The clinical and histological features were compared between those with and without intrahepatic HDAg expression. Intrahepatic HDAg expression was detected in 15 (15.5%) of the 97 patients. All of the 15 were males between 18 and 71 years of age. Each had elevated SGPT levels, with 46.8% being greater than 10 times normal and 73.4% greater than five times normal. Histological study revealed chronic lobular hepatitis in nine and chronic active hepatitis in six, including two with cirrhosis. Compared to the 82 patients without intrahepatic HDAg expression, no difference in the age (34.1±14.3 vs 36.7±10.8) and sex (15:0 vs 72:10) distribution was evident, but greater biochemical and histological activity was present in HDV-positive patients.