[Investigation of anticardiolipin antibodies in chronic hepatitis B infection together with total anti-delta positivity]. / Kronik hepatit B enfeksiyonu ile birlikte total anti-delta pozitifliginde antikardiyolipin antikorlarinin arastirilmasi.

Anticardiolipin antibodies (ACAs) are formed against phospholipids in various clinical conditions such as autoimmune diseases, malignancy, infectious diseases, alcohol-related and hepatic cirrhosis. The aims of this study were to investigate the presence of ACAs in patients with chronic hepatitis B together with positive total anti-delta antibodies, and to investigate the relationship between age, gender, and some laboratory parameters (ALT, AST, albumin, globulin, platelet number) of patients with chronic hepatitis delta virus (HDV) infection, who were positive or negative for ACAs. A total of 60 patients (43 male, 17 female) with chronic hepatitis D infection [HBsAg positive, HBeAg negative, anti-HBe positive, anti-HBc IgG positive, anti-HBc IgM negative, total anti-delta positive, anti-HCV negative] and 30 patients (21 male, 9 female) without hepatitis D infection [HBsAg positive, HBeAg negative, anti-HBe positive, anti-HBc IgG positive, anti-HBc IgM negative, total anti-delta negative, anti-HCV negative] as control group were included to the study. ACA IgG and IgM were searched by a commercial microELISA kit (Euroimmun, Germany). The statistical evaluation was performed with Pearson's chi-square test, Student's t-test, and Fisher's exact test. Total ACAs positivity rate of 60 patients with chronic HDV infection, was found as 13.3%, in which four of the patients were positive for only ACA IgM, while four was positive for only IgG. Positivity for both ACA IgG and ACA IgM could not be detected in these patients. No patients in the control group had positivity for ACAs (IgG and/or IgM). A statistically significant difference was observed in terms of ACA positivity between patients with and without HDV infection (p< 0.05). After all, there was no statistically significant correlation between ACAs positivity and the age, sex, and laboratory parameters of the patients with chronic HDV infection, except lower serum albumin levels (p= 0.004). Although the data of this study revealed a statistically significant positive correlation between chronic HDV infection and anticardiolipin antibodies, it is clear that there is a need for further studies on this subject.

[Investigation of autoantibody, anti-HCV and anti-HIV seropositivities in "anti-HBc alone" positive samples]. / SALT Anti-HBc Pozitif orneklerde otoantikor, anti-HCV ve anti-HIV seropozitifliginin arastirilmasi.

"Anti-HBc alone" which is an unusual serologic pattern of hepatitis B virus (HBV) infections, may be detected in the seropositive samples for hepatitis C virus (HCV), human immunodeficiency virus (HIV) infections and in the presence of autoantibodies due to cross reactions. In this study, 20 serum samples with isolated antibody to hepatitis B core antigen, which were detected in May 2005, have been investigated by means of the presence of some autoantibodies (anti-nuclear antibody; ANA and rheumatoid factor; RF), anti-HCV and anti-HIV, in the Central Laboratory of Dicle University Medical School. All of the "anti-HBc alone" samples were negative for HBV-DNA by real-time polymerase chain reaction (PCR), and liver enzyme (ALT and AST) levels were normal except for three patients. As a result, a total of six (30%) samples were found positive. Four of them were positive for ANA and two were positive for anti-HCV, while one serum yielded positivity for both ANA and anti-HCV. Anti-HCV positive samples were searched for the presence of HCV-RNA by real-time PCR, and none were found positive. Of three patients with increased AST and ALT levels, one was anti-HCV positive, one was ANA positive, while the other was negative for all parameters. In conclusion, possible presence of autoantibodies and anti-HCV should be taken into consideration during the evaluation of isolated anti-HBc IgG positive test results.

[Short communication: evaluation of the correlation between hepatitis D virus (HDV) RNA positivity and HDV antibodies]. / Kisa bildiri: hepatit D virus (HDV) RNA pozitifligi ile HDV antikorlari arasindaki iliskinin degerlendirilmesi.

The objective of this study was to evaluate the correlation between serum hepatitis D -delta- virus (HDV) RNA detection and anti-HDV IgG and IgM antibodies, in the serodiagnosis of delta hepatitis. A total of 153 HBsAg positive sera were screened for the presence of anti-HBc IgM, anti-HDV IgG and anti-HDV IgM by commercial enzyme immunoassays and HDV-RNA by real time polymerase chain reaction (PCR). Of 153 sera, 86 (56.2%) were found positive for HDV antibodies. Although isolated anti-HDV IgG was present in 35 and isolated anti-HDV IgM was present in 11 patients, IgG and IgM were present concurrently in 40 additional patients. HDV-RNA was detected in 21.5% (33/153) of the patients. Four of the 33 HDV-RNA positive patients were positive only for anti-HDV IgG, 8 were positive only for anti-HDV IgM, and 19 were positive for both anti-HDV IgG and IgM antibodies. Twenty seven of 51 (53%) anti-HDV IgM positive patients were also found positive for HDV-RNA, while 27 of 33 (82%) HDV-RNA positive patients exhibited anti-HDV IgM positivity. Increased serum ALT levels were detected approximately in 85% (28/33) of viremic patients. As all of the HDV-RNA positive patients were found negative for anti-HBc IgM, superinfection with delta virus were considered. In conclusion, PCR is a sensitive and useful method for the detection of viremic patients as well as for the monitorization of antiviral therapy, anti-HDV IgM positivity together with increased ALT levels appear to be good markers for the prediction of hepatitis delta viremia, especially in the countries with limited economical sources as Turkey.