hepatitis D virus (delta agent, HDV)
Jump to navigation
Jump to search
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
- relatively uncommon in North America
- areas of higher prevalence in Eastern Europe, Southern Europe, the Mediterranean region, the Middle East, West & Central Africa, East Asia, & the Amazon Basin[1]
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
- ↑ 1.0 1.1 Medical Knowledge Self Assessment Program (MKSAP) 11, 14. American College of Physicians, Philadelphia 1998, 2006.
Medical Knowledge Self Assessment Program (MKSAP) 20 American College of Physicians, Philadelphia 2025 - ↑ 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
- ↑ Rizzetto M, Hamid S, Negro F. The changing context of hepatitis D. J Hepatol. 2021;74:1200-1211. PMID: https://pubmed.ncbi.nlm.nih.gov/33484770