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Canadian Journal of Gastroenterology
Volume 2, Issue 4, Pages 151-155
Clinical Gastroenterology

Hepatitis Delta Infections in Toronto, Ontario

S. Victor Feinman,1 Barnet Berris,1 John L. Gerin,2 and Robert H. Purcell3

1Liver Srudy Unit, Department of Medicine unit Reseurch, Mount Sinai Hospital, University of Toronto, Toronro, Ontario, Canada
2Division of Molecular Biology and Immunology, Georgetown University, Washingwn DC, USA
3Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institute of health, USA

Received 27 June 1988; Accepted 22 August 1988

Copyright © 1988 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


This study assessed the prevalence of hepatitis delta virus infection, the relation of this infection to the clinical and histological status and to the geographic origin of 216 patients with hepatitis B virus infection in Toronto, Ontario. Evidence of delta infection was present in 13 of the 216 patients (6.0%). It was more common in patients with acute hepatitis (11.1%) and with chronic hepatitis (16.7%) than in asymptomatic carriers (3.6%). It was not present in the three patients with hepatocellular carcinoma. The clinical course of the two patients with acute hepatitis and delta markers was similar to patients with hepatitis B alone and both made a complete recovery. Of the five patients with chronic liver disease and delta markers, three had severe chronic active hepatitis. Three of the 13 patients with delta infection were born in Canada. All three patients were intravenous drug abusers. Of the 10 patients not born in Canada, eight were immigrants from countries where delta infection is endemic. The remaining two were from West Germany and China. From this study it was concluded that, in Toronto, delta infection was more common in patients with acute and chronic hepatitis B than in asymptomatic carriers. Patients with both acute hepatitis Band delta infection had a similar clinical course to patients with acute hepatitis B alone. Patients with chronic hepatitis B and delta infection frequently had severe chronic active hepatitis. In Canadian-born patients delta infection was present in intravenous drug abusers only. Most immigrants with evidence of delta infection came from countries where delta is endemic.