Evaluation of follow-up results of patients followed up with chronic hepatitis D diagnosis in our clinic

Objective: This study aims to retrospectively evaluate the laboratory data of patients diagnosed with Hepatitis D, along with long-term clinical outcomes such as cirrhosis and hepatocellular carcinoma (HCC). Materials and Methods: Patients with positive Delta antibody results who presented to the outpatient clinics of Adıyaman Training and Research Hospital between 2012 and 2025 were retrospectively analyzed. Within this group, patients were classified based on their HDV RNA status as positive, negative, or not tested. Additionally, patients diagnosed with Hepatitis B were also included in the study. Laboratory findings and clinical courses of the patients were comparatively evaluated over the years. Results: Among the 141 patients who were positive for Delta antibody, 51.10% (n=72) were male and 48.90% (n=69) were female. Of the 51 patients with positive HDV RNA results, 66.70% (n=34) were male and 33.30% (n=17) were female. Regarding age at diagnosis, the youngest patient among the 141 participants was 25 years old, while the oldest was 78 years old. The mean age was 47.33 years. Concerning the initial HDV RNA results of the 141 patients, 35.50% (n=50) were positive, 51.80% (n=73) were negative, and 12.80% (n=18) were not tested for HDV RNA. Among the patients, 61.70% (n=87) were receiving treatment for Hepatitis B, whereas 38.30% (n=54) were not treated. The latest HBV DNA results showed that 86.50% (n=122) of patients had negative values, while 13.50% (n=19) were not tested for HBV DNA. Regarding antiviral therapy, 16.30% (n=23) of the patients were using Entecavir, 40.40% (n=57) Tenofovir Disoproxil, 5.00% (n=7) Lamivudine, and 38.30% (n=54) were not on any medication. Among the 51 patients with an initial positive HDV RNA result, 3.90% (n=2) had died (exitus), while 96.10% (n=49) were alive. Of the 87 patients receiving Hepatitis B treatment, 90.80% (n=79) had negative final HBV DNA results, and 9.20% (n=8) had no follow-up HBV DNA data. The last ultrasound (USG) findings of the 141 patients showed that 77.30% (n=109) had normal liver imaging, 21.30% (n=30) had cirrhosis, and 1.40% (n=2) had both cirrhosis and hepatocellular carcinoma (HCC).Among the 51 patients initially positive for HDV RNA, those who received treatment ("Yes" group) had final HDV RNA results showing 52.00% positive and 48.00% negative. In contrast, patients who did not receive treatment ("No" group) had 69.20% positive and 30.80% negative final HDV RNA results. Conclusion: In our study, the relatively low number of patients diagnosed with active delta hepatitis among those who were anti-HDV positive highlights the critical role of HDV RNA testing in establishing an accurate diagnosis. We also observed that a considerable proportion of patients diagnosed with Hepatitis B had not been tested for anti-HDV, suggesting a significant gap in screening practices. Furthermore, the high rate of treatment success among Hepatitis B patients underscores the effectiveness of current antiviral therapies. The absence of routine anti-HDV testing in standard Hepatitis B screening protocols suggests the need for a more comprehensive diagnostic approach. Our findings support the recommendation that all patients diagnosed with Hepatitis B should be screened for anti-HDV, and if positive, further evaluated for HDV RNA to confirm active infection. This approach would enhance both the diagnosis and management of delta hepatitis. Although pegylated interferon—currently considered the most effective available treatment—contributed partially to HDV RNA clearance, it appeared insufficient in preventing the progression to cirrhosis and hepatocellular carcinoma (HCC). Among those receiving treatment for delta hepatitis, we found that 48% (n=12) achieved a successful treatment outcome. Keywords: Hepatitis Delta Virus, Hepatocellular Carcinoma, Pegylated Interferon, Antiviral Therapy, Cirrhosis