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Hepatitis D Virus

by | 4 Dec, 2020

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Introduction

Hepatitis D virus (HDV) is a deltavirus that is dependent on hepatitis B virus (HBV) for replication. It can infect individual simultaneously with HBV (co-infection) or superinfect those who are already chronic carriers of HBV.

HDV infection is particularly seen in IV drug users.

Epidemiology

Endemic to Africa, South America and Mediterranean Basin

Clinical features

Co-infections with HBV

Clinically indistinguishable from an acute icteric HBV infection, although usually has severe symptoms.

Superinfections in chronic carriers of HBV

Results in an acute flare-up of previously inactive chronic HBV infection. This is usually followed by spontaneous recovery. An increase in ALT may the only indication of infection. Occasionally, there may be simultaneous recovery of HBC and HDV.

Chronic infection with HBV and HDV frequently causes rapid progression to chronic hepatitis and cirrhosis.

Investigations

Anti-HDV antibodies are the principal investigation. Co-infection produces low titres (usually IgM), while superinfection results in high titres (IgM initially, then IgG).

Management

There is no specific treatment for HDV. Management relies on adequately controlling HBV.

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