ABSTRACT
A high level of contamination with hepatitis delta virus (HDV) in central Kazakhstan was established. Infection mainly occurred in the process of common injections. The possibility of the horizontal and vertical spread of this infection was shown. Sharp distinctions in the course and outcomes of delta co- and superinfections in children were found. In most children superinfection was manifested by a severe course, and in almost all children by the development of chronic active hepatitis (CAH). The latter was characterized by pronounced clinical symptoms, prolonged relapsing course, infrequent stabilization (in one third of patients observed from the age of 7 to 12 years, the development of cirrhosis of the liver. The differences in the course of co- and superinfection may be explained by different relationships between hepatitis B virus and HDV in these forms of infection, and the prolonged unfavorable course of CAH may be regarded as a consequence of the appearance of profound and stable immunodeficiency.
