hepatitis D virus (delta agent, HDV)
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Introduction
Only infects patients with concurrent hepatitis B virus (HBV) infection.
Epidemiology
- incidence highest with repeated percutaneous exposures
- when HDV infection occurs simultaneously with HBV infection, both infections tend to be self-limited
- when HDV superinfects established HBV infection, more severe clinical hepatitis & chronic HDV infection occurs
Pathology
- HDV suppresses HBV replication
- requires HBsAg to become an infectious virus
- HDAg may interfere with RNA production & produce cell damage
Clinical manifestations
- more severe acute hepatitis than with HBV alone
- increased risk of fulminant hepatitis
- more chronic hepatitis with increased risk of cirrhosis (70-80%) than with HBV alone
Laboratory
- hepatitis D serology
- hepatitis D antigen (HDAg) indicates active infection
- serum HBeAg is negative (HBV replication is suppressed)
- Hepatitis D virus RNA
- see ARUP consult[3]
Management
- prevention: elimination of high-risk behavior
- interferon alpha results in temporary reduction of HDV levels with relapse upon discontinuation of therapy
More general terms
Additional terms
References
- ↑ Medical Knowledge Self Assessment Program (MKSAP) 11, 14. American College of Physicians, Philadelphia 1998, 2006.
- ↑ Clinical Guide to Laboratory Tests, 3rd ed. Teitz ed., W.B. Saunders, 1995
- ↑ 3.0 3.1 ARUP Consult: Hepatitis Delta Virus - HDV The Physician's Guide to Laboratory Test Selection & Interpretation https://www.arupconsult.com/content/hepatitis-delta-virus