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hepatitis D infection
Pathology:
1) requires hepatitis B virus for replication
a) coinfects with hepatitis B virus
b) superinfects hepatitis B carrier
2) parenteral & permucosal transmission
3) incubation period 4-6 months
4) may accelerate development of cirrhosis
5) occasionally causes fulminant acute hepatitis
Laboratory:
- hepatitis B antigen positive
- hepatitis B core IgG positive, IgM negative
- hepatitis B e antigen negative
- hepatitis A IgM negative
- hepatitis C Ab &/or hepatitis C viral load negative
- serum ALT may be > serum AST, both very high (>1000 U/L)
- serum alkaline phosphatase may be 2-fold upper limit of normal
- serum bilirubin (total) may be 9-fold upper limit of normal
- hepatitis D antibody (anti-HDV)
- becomes positive 15 weeks after signs/symptoms
- not protective
- see viral hepatitis
Management:
- no treatment
- hepatitis B vaccine is preventative
Related
hepatitis D virus (delta agent, HDV)
General
viral hepatitis
References
- NEJM Knowledge+ Gastroenterology
- Negro F, Lok LS.
Hepatitis D. A Review.
JAMA. Published online November 9, 2023
https://jamanetwork.com/journals/jama/fullarticle/2811969