Hepatitis D virus infection in patients with hepatitis B virus occult infection

OUBIÑA, JOSÉ R.; DELFINO, CECILIA M.; MATHET, VERÓNICA L.

EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY

LIPPINCOTT WILLIAMS & WILKINS

Año: 2019 vol. 31

0954-691X

Aguilera et al. [1] have clearly confirmed the usefulness oflooking for hepatitis D virus (HDV) in patients showingHBsAg reactivity in serum. However, Ponzetto et al. [2],have accurately emphasized the fact that HDV infection mayalso occur even in the absence of HBsAg detection in serum,as previously showed both in animal models, as well as inhumans. Moreover, such results have been recently supportedby the dazzling discovery that HDV might be transmittedfrom infected hepatocytes to descendent cells in spite of theabsence of a concomitant HBV infection [3].In addition to these studies, we have been able to observeHDV infections among Amerindian patients with HBV occultinfection [4]. Moreover, we also detected HDV RNA inpatients without detectable serological markers for HDV antibodiesby using the Food and Drug Administration-approvedenzyme-linked immunosorbent assay kits. Such an unexpectedresult has been preliminarily ascribed to the highly divergentnucleotide-deduced amino-acidic sequence of the HDVAgrecorded among some South American patients [4,5], whichmight, in turn, account for an inadequate recognition of commerciallyavailable anti-HDV antibodies, as observed in duplicatein two independent enzyme-linked immunosorbent assayexperiments using different commercial lots [4]. This hypothesiswas initially proposed, also taking into consideration the dissimilarhydrophobicity plot of the deduced HDAg sequencesfrom some Amerindian patients, as compared with an HDV-1reference sequence. To further explore this hypothesis, experimentalapproaches with recombinant HDVAg mutants are inprogress in our lab.