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  • Title: The role of hepatitis D virus in liver disease in the Middle East.
    Author: Toukan AU, al-Kandari S.
    Journal: Prog Clin Biol Res; 1991; 364():63-8. PubMed ID: 2020722.
    Abstract:
    Hepatitis D virus appears to be endemic in the Middle East, but its distribution bears little relationship to that of HBV. Only in Jordan was an association between HDV-positive status and HBsAg-positive primary hepatocellular carcinoma found. Fulminant hepatitis and chronic sequelae were unusual in HDV-coinfection, while early mortality and a chronic outcome were commoner in HDV-superinfection. In established HBsAg-positive cirrhosis survival was not significantly different in the HDV-positive vs. the HDV-negative patients. In patients whose biopsies showed cirrhosis, severe necroinflammatory features were seen more often in the HDV-positive than in HDV-negative patients.
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