Does chronic delta hepatitis increase risk of celiac disease?

Celiac disease is a small intestinal malabsorption syndrome whose importance remains underappreciated. This is underestimated by the fact that it remains under recognized in almost 90% of patients. Hepatitis D virus (HDV) infection is a serious health problem leading to cirrhosis and hepatocellular carcinoma. Furthermore, the impact of on the clinical picture in patients with chronic HDV infection, with regards to laboratory parameters is not clear. So, we examined this relationship using recent hospital-based data. We analyzed data from 50 delta hepatitis patients (mean age 52.5 +/- 12.8 years; 30 male). 21 of them had cirrhosis. Both groups were screened for serum tissue transglutaminase antibodies and immunoglobulin A, and those antibody-positive were further investigated by intestinal biopsy. Histopathological examination was performed according to Marsh classification. Demographic features and laboratory data were compared between groups. There were six (28.5%) seropositivity of TTG IgG among patients with delta hepatitis related cirrhosis. No patient tested positive for TTG IgA in cirrhotic group whereas, there were no positive results for both TTG IgA and G among non-cirrhotic delta hepatitis group. In cirrhotic group, the rate of TTG IgG seropositivity was higher than those without cirrhosis (p=0.036). Seropositivity of TTG IgG was correlated with higher MELD scores (p<0.05). Higher rate of seropositivity of TTG IgG antibodies and CD among patients with chronic HDV-related cirrhosis may reflect a unique phenomenon that requires further investigation to determine underlying causative factors.