Abstract
To the Editor: We read with interest the review on hepatitis delta in children by Xue et al in the Journal of Pediatric Gastroenterology and Nutrition(1). We were surprised to find that the authors do not mention the article we published in Hepatology(2), which reported the first data on hepatitis delta infection in children. Among 102 children with chronic hepatitis B investigated for the evidence of delta infection, we found 13 children (12.7%) who exhibited serological evidence of delta infection with intrahepatic delta antigen detected by immunohistochemistry in 10. All of them had severe progressive liver disease. We also identified factors, including geographic origin, history of exposure to blood derivatives and age, which increase the risk of acquiring delta infection in children who are hepatitis B virus carriers. Given the limited number of children reported with delta hepatitis in the literature and the fact that all but 3 of the patients in the article by Xue at al (1) were reported 20 years ago or earlier, the original series we published in 1985 (2) should be included in a review of delta hepatitis in pediatric patients.
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