Clinical evolution of hepatitis delta virus genotype 3 infection in patients from the Western Amazon, Brazil

Background: Chronic infection with the Hepatitis Delta Virus (HDV) is often associated with severe liver decompensation and fulminant hepatitis, but in some cases, it can present a stable clinical presentation. Objectives: This study evaluated the clinical evolution of HDV-3 carriers from an endemic region of the western Brazilian Amazon. Methods: Cross-sectional study was carried out with Anti-HDAg reagent patients, seen at an outpatient clinic specialized in viral hepatitis located in Rondônia, Brazil. Findings: A total of 19 patients, 68.4% male and 31.6% female, aged between 23 and 65 years old, were evaluated; 84.2% were clinically classified as carriers of the decompensated disease and 15.8% as carriers of the inactive disease. The results of the clinical evaluation were related to viral load; 30.8% had detectable viral RNA, and even though it was not possible to establish an association between the stage of the disease and persistent viral replication (p> 0.05), persistent viral replication was predictive of early evolution for liver cirrhosis. Conclusion: The results demonstrate the possibility that viral load can be used as a noninvasive hepatic marker in the clinical management of Hepatitis Delta.