Search
hepatitis D virus (delta agent, HDV)
RNA virus.
Only infects patients with concurrent hepatitis B virus (HBV) infection.
Epidemiology:
1) incidence highest with repeated percutaneous exposures
a) injection drug users
b) hemophilia
2) when HDV infection occurs simultaneously with HBV infection, both infections tend to be self-limited
3) when HDV superinfects established HBV infection, more severe clinical hepatitis & chronic HDV infection occurs
Pathology:
1) HDV suppresses HBV replication
2) requires HBsAg to become an infectious virus
3) HDAg may interfere with RNA production & produce cell damage
Clinical manifestations:
1) more severe acute hepatitis than with HBV alone
2) increased risk of fulminant hepatitis
3) more chronic hepatitis with increased risk of cirrhosis (70-80%) than with HBV alone
Laboratory:
1) hepatitis D serology
2) hepatitis D antigen (HDAg) indicates active infection
- hepatitis D antigen in serum
- hepatitis D antigen in urine
- immunohistochemical staining of liver tissue
4) serum HBeAg is negative (HBV replication is suppressed)
5) Hepatitis D virus RNA
6) see ARUP consult [3]
Management:
1) prevention: elimination of high-risk behavior
2) interferon alpha results in temporary reduction of HDV levels with relapse upon discontinuation of therapy
Related
hepatitis D virus RNA
hepatitis virus
viral hepatitis
General
defective virus
Properties
KINGDOM: virus
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
- ARUP Consult: Hepatitis Delta Virus - HDV
The Physician's Guide to Laboratory Test Selection & Interpretation
https://www.arupconsult.com/content/hepatitis-delta-virus