The prevalence of delta virus infection in chronic liver disease in Egyptian children in comparison with some other countries.

BACKGROUND: Hepatitis Delta Virus (HDV) infection has a worldwide distribution. The aim of this study was to establish its prevalence in Egyptian children with chronic liver disease, and its role in the development and progress of hepatic illness. METHODS: A prospective study of 45 Egyptian children who had liver cirrhosis (n = 24) or chronic hepatitis (n = 21) was done. They were consecutively chosen. Their ages ranged from 2-15 years (median = 5). Serological studies were performed to detect the presence of hepatitis B surface antigen (HBs Ag) and HDV infection IgG antibody (IgG anti-HD). RESULTS: Anti-delta antibody (IgG anti-HD) was detected in only four children with hepatic cirrhosis and non of the chronic hepatitis, with an overall prevalence of 8.9% (4/45). Three of them (75%) were hepatitis B surface antigen (HBs Ag) negative. Significant statistical association between delta infection and the state of hepatic illness was detected (p < 0.05). Whereas HBs Ag was detected in 54% (13/24) of liver cirrhosis and 52% (11/21) of chronic hepatitis, with an overall prevalence of 53% (24/45). There was no statistically significant association between HBs Ag positivity and state of hepatic illness. CONCLUSIONS: The prevalence of HDV infection is 8.9% of Egyptian children with chronic liver disease. HDV infection in children is associated with advanced chronic liver disease.

Demonstration of antibodies to human T-cell lymphotropic virus-I tax in patients with the cutaneous T-cell lymphoma, mycosis fungoides, who are seronegative for antibodies to the structural proteins of the virus.

Although most patients with the cutaneous T-cell lymphoma, mycosis fungoides (MF), are seronegative for human T-cell lymphotropic virus-I or -II (HTLV-I/II) when tested by assays that measure only antibodies to the viral structural proteins, the majority of such patients harbor HTLV-I-related pol and tax proviral sequences that encode proteins not included in routinely used serologic tests. Tax mRNA has also been detected in their peripheral blood mononuclear cells (PBMC). Therefore, it seemed possible that these patients have antibodies to the tax protein. To investigate this, enzyme-linked immunosorbent assays (ELI-SAs) and Western blot assays were set up, using as antigens the full-length HTLV-I tax cloned from the prototypic HTLV-I-infected cell line, C91PL, and from PBMC of a MF patient, as well as a synthetic peptide made to the carboxy-terminal 20 amino acids of tax-I. Of 60 MF patients whose PBMC were shown to be positive for tax proviral DNA and mRNA, 50 (83%) were shown to have tax antibodies. The antigen derived from the MF patient was most useful in detecting such antibodies. These results demonstrate the need for including other HTLV-related antigens in addition to gag and env in serologic tests used to identify HTLV-infected individuals. The findings underscore the fact that individuals considered seronegative on the basis of currently used tests can be infected with HTLV.

Delta virus and hepatitis B surface antigen in chronic liver diseases.

This work was carried out on 45 patients with chronic liver diseases, including 24 cases of liver cirrhosis and 21 cases of chronic hepatitis. Their ages ranged from 2 to 15 years (median 5). All cases were examined clinically and assessed biochemically for liver function tests. Serological studies were performed to detect hepatitis B surface antigen (HBsAg) and delta IgG antibody (IgG anti-HD) using Enzyme Immunoassay (EIA) technique. The study showed that IgG anti-HD was detected in 8.9% of cases with chronic liver diseases (all positive cases were with liver cirrhosis). On the other hand, HBsAg was detected in 53.3% of cases (54.2% of them with cirrhosis and 45.8% with chronic hepatitis) with no significant association between HBsAg positivity and type of hepatic illness. Moreover, IgG anti-HD was positive in only 4.2% of HBsAg positive cases, while 14.3% of HBsAg negative cases were positive for IgG anti-HD. A significant association was also found between delta positivity and serum glutamic oxaloacetic transferase level (SGOT). We concluded that chronic delta hepatitis appeared to be more severe than other types of chronic viral hepatitis, as all delta positive cases were with liver cirrhosis and had elevated SGOT levels. Screening of delta markers in addition to hepatitis B viral markers could improve the understanding of a number of obscure cases of chronic hepatic illnesses and would help in the control of HBV and consequently HDV infection in the general population.