Hepatitis delta infections in Toronto, Ontario

Abstract

This study assessed the prevalence of hepatitis delta virus infection, the relation of this infection to the clinical and histological status and to the geographic origin of 216 patients with hepatitis B virus infection in Toronto, Ontario. Evidence of delta infection was present in 13 of the 216 patients (6.0%). It was more common in patients with acute hepatitis (11.1%) and with chronic hepatitis (16.7%) than in asymptomatic carriers (3.6%). It was not present in the three patients with hepatocellular carcinoma. The clinical course of the two patients with acute hepatitis and delta markers was similar to patients with hepatitis B alone and both made a complete recovery. Of the five patients with chronic liver disease and delta markers, three had severe chronic active hepatitis. Three of the 13 patients with delta infection were born in Canada. All three patients were intravenous drug abusers. Of the 10 patients not born in Canada, eight were immigrants from countries where delta infection is endemic. The remaining two were from West Germany and China. From this study it was concluded that, in Toronto, delta infection was more common in patients with acute and chronic hepatitis B than in asymptomatic carriers. Patients with both acute hepatitis B and delta infection had a similar clinical course to patients with acute hepatitis B alone. Patients with chronic hepatitis B and delta infection frequently had severe chronic active hepatitis. In Canadian-born patients delta infection was present in intravenous drug abusers only. Most immigrants with evidence of delta infection came from countries where delta is endemic.