To evaluate the effect of hepatitis delta virus on the level of replication of hepatitis B virus and to assees the clinical significance that such an effect might have on the find oatcome of the infection, the serological profile of hepatitis B virus DNA was investigated in 153 patients with acute or chronic hepatitis B virus infection with or without associated delta infection. Serum hepatitis B virus DNA was detected in 57% of patients with mute hepatitis B, 87% of those with acute hepatitis B v b h e p a t i t i s delta virus coinfection and 26% of HBBAg carriers with hepatitis delta virus superinfection during the first week after the onset of symptoms. Patienta with acute hepatitis B and those with acute hepatitia B virus-hepatitis delta virus coinfection did not differ significantly with respect to the serological profile of hepatitis B virus DNA and final clinical outcome. Within the group of HBsAg carriers with hepatitis delta v h superinfection, all patients who were initially negative for hepatitis B virus DNA developed chronic hepatitis delta virus infection, whereas 3 of the 4 patients with active hepatitis B virus infection at the time of superinfection showed transient inhibition of hepatitis B virus replication followed by termination of hepatitis delta virus infection in two patients. Therefore, altheugh delta virus may inhibit the replication of hepatitis B virus among chronic HBsAg carriers, this effect i s not readily apparent among patients with hepatitis B virus-hepatitis delta virus coinfection.
The presence of hepatitis B virus DNA (HBV DNA) in the serum of patients with acute hepatitis B has been the subject of several recent studies which have attempted to evaluate the utility of this marker to predict the development of chronic liver disease (1-5). In this regard, these reports have suggested that both the level and the persistence of HBV DNA in the serum may be prognostic markers for the outcome of acute infection. Few studies, however, have investigated this marker in patients with acute hepatitis delta virus (HDV) infection