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Long-Term Study of ...
Long-Term Study of Hepatitis Delta Virus Infection at Secondary Care Centers: The Impact of Viremia on Liver-Related Outcomes
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- Kamal, H. (author)
- Department of Infectious Diseases, Karolinska University Hospital, Sweden; Department of Medicine Huddinge, Karolinska Institutet, Sweden,Karolinska Univ Hosp, Dept Infect Dis, Stockholm, Sweden.;Karolinska Inst, Dept Med Huddinge, Stockholm, Sweden.
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- Westman, Gabriel, 1977- (author)
- Uppsala universitet,Infektionsmedicin,Uppsala Univ, Sweden
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- Falconer, K. (author)
- Karolinska Institutet
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- Duberg, Ann-Sofi, Docent, 1957- (author)
- Department of Infectious Diseases, Örebro University Hospital, Sweden,Örebro Univ Hosp, Dept Infect Dis, Örebro, Sweden.
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- Weiland, O. (author)
- Karolinska Institutet
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- Haverinen, S. (author)
- Department of Infectious Diseases, Karolinska University Hospital, Sweden,Karolinska Univ Hosp, Dept Infect Dis, Stockholm, Sweden.
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- Wejstal, R. (author)
- Department of Infectious Diseases, Sahlgrenska University Hospital, Sweden,Sahlgrens Univ Hosp, Dept Infect Dis, Gothenburg, Sweden.
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- Carlsson, T. (author)
- Department of Infectious Diseases, Danderyd University Hospital, Sweden,Danderyd Hosp, Dept Infect Dis, Stockholm, Sweden.
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- Kampmann, C. (author)
- Department of Infectious Diseases, Skåne University Hospital Lund, Sweden,Skane Univ Hosp Lund, Dept Infect Dis, Lund, Sweden.
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- Larsson, Simon B. (author)
- Gothenburg University,Göteborgs universitet,Institutionen för biomedicin, avdelningen för infektionssjukdomar,Institute of Biomedicine, Department of Infectious Medicine,Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Sweden,Univ Gothenburg, Sahlgrenska Acad, Inst Biomed, Dept Infect Dis, Gothenburg, Sweden.
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- Bjorkman, P. (author)
- Department of Infectious Diseases, Skåne University Hospital Malmö, Sweden,Skane Univ Hosp Malmö, Dept Infect Dis, Malmö, Sweden.
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- Nystedt, A. (author)
- Department of Infectious Diseases, Sunderby Hospital, Sweden,Sunderby Hosp, Dept Infect Dis, Luleå, Sweden.
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- Cardell, K. (author)
- Department of Infectious Diseases, Sunderby Hospital, Sweden,Sunderby Hosp, Dept Infect Dis, Luleå, Sweden.
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- Svensson, Stefan (author)
- Karolinska Institutet,Linköpings universitet,Institutionen för biomedicinska och kliniska vetenskaper,Medicinska fakulteten,Region Östergötland, Infektionskliniken i Östergötland
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- Stenmark, S. (author)
- Department of Infectious Diseases, University Hospital of Umeå, Sweden,Univ Hosp Umeå, Dept Infect Dis, Umeå, Sweden.
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- Wedemeyer, H. (author)
- Department of Gastroenterology and Hepatology, University of Essen,Univ Essen Gesamthsch, Dept Gastroenterol & Hepatol, Essen, Germany.
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- Aleman, S. (author)
- Department of Infectious Diseases, Karolinska University Hospital, Sweden; Department of Medicine Huddinge, Karolinska Institutet, Sweden,Karolinska Univ Hosp, Dept Infect Dis, Stockholm, Sweden.;Karolinska Inst, Dept Med Huddinge, Stockholm, Sweden.
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Department of Infectious Diseases, Karolinska University Hospital, Sweden; Department of Medicine Huddinge, Karolinska Institutet, Sweden Karolinska Univ Hosp, Dept Infect Dis, Stockholm, Sweden;Karolinska Inst, Dept Med Huddinge, Stockholm, Sweden. (creator_code:org_t)
- 2020-09-24
- 2020
- English.
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In: Hepatology. - : Ovid Technologies (Wolters Kluwer Health). - 0270-9139 .- 1527-3350. ; 72:4, s. 1177-1190
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Abstract
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- Background and Aims Hepatitis delta virus (HDV) infection is associated with fast progression to liver cirrhosis and liver complications. Previous studies have, however, been mainly from tertiary care centers, with risk for referral bias toward patients with worse outcomes. Furthermore, the impact of HDV viremiaper seon liver-related outcomes is not really known outside the human immunodeficiency virus co-infection setting. We have therefore evaluated the long-term impact of HDV viremia on liver-related outcomes in a nationwide cohort of patients with hepatitis B and D co-infection, cared for at secondary care centers in Sweden. Approach and Results In total, 337 patients with anti-HDV positivity, including 233 patients with HDV RNA viremia and 91 without HDV viremia at baseline, were retrospectively studied, with a mean follow-up of 6.5 years (range, 0.5-33.1). The long-term risks for liver-related events (i.e., hepatocellular carcinoma [HCC], hepatic decompensation, or liver-related death/transplantation) were assessed, using Cox regression analysis. The risk for liver-related events and HCC was 3.8-fold and 2.6-fold higher, respectively, in patients with HDV viremia compared with those without viremia, although the latter was not statistically significant. Among patients with HDV viremia with no baseline cirrhosis, the cumulative risk of being free of liver cirrhosis or liver-related events was 81.9% and 64.0% after 5 and 10 years of follow-up, respectively. This corresponds to an incidence rate of 0.04 cases per person-year. Conclusions HDV RNA viremia is associated with a 3.8-fold higher risk for liver-related outcomes. The prognosis was rather poor for patients with HDV viremia without cirrhosis at baseline, but it was nevertheless more benign than previous estimates from tertiary centers. Our findings may be of importance when making decisions about treatment and evaluating potential outcomes of upcoming antivirals against HDV.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Gastroenterologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Gastroenterology and Hepatology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Infektionsmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Infectious Medicine (hsv//eng)
Keyword
- b surface-antigen
- interferon
- prevalence
- cirrhosis
- risk
- therapy
- pattern
- mortality
- fibrosis
- disease
- Gastroenterology & Hepatology
- Cirrhosis
Publication and Content Type
- ref (subject category)
- art (subject category)
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Hepatology
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- By the author/editor
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Kamal, H.
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Westman, Gabriel ...
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Falconer, K.
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Duberg, Ann-Sofi ...
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Weiland, O.
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Haverinen, S.
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Wejstal, R.
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Carlsson, T.
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Kampmann, C.
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Larsson, Simon B ...
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Bjorkman, P.
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Nystedt, A.
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Cardell, K.
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Svensson, Stefan
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Stenmark, S.
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Wedemeyer, H.
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Aleman, S.
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Gastroenterology ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Infectious Medic ...
- Articles in the publication
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Hepatology
- By the university
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University of Gothenburg
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Örebro University
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Uppsala University
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Linköping University
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Karolinska Institutet