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Review
. 2015 Oct 8;7(22):2389-95.
doi: 10.4254/wjh.v7.i22.2389.

Hepatitis delta virus: Making the point from virus isolation up to 2014

Raffaella Romeo  1 , Riccardo Perbellini  1
Affiliations
Review

Hepatitis delta virus: Making the point from virus isolation up to 2014

Raffaella Romeo et al. World J Hepatol. .

Abstract

Chronic infection with hepatitis delta virus (HDV) has lately regained clinical importance because of the recent evidence of increasing prevalence in several European countries, due to immigration from highly endemic areas. HDV requires the mandatory presence of hepatitis B virus (HBV) for propagation to hepatocytes. It is transmitted by the same routes of HBV and it can be acquired either by co-infection (simultaneous transmission of the two viruses) or super-infection (acquisition of HDV by an already chronic carrier of HBV). As a consequence, every HBV carrier is potentially at risk for HDV superinfection. Since the clinical course of super-infection can be severe, early diagnosis of HDV infection is necessary.

Keywords: Epidemiology; Hepatitis delta virus; Natural history; Treatment.

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Figures

Figure 1
Figure 1
Estimated world epidemiology of hepatitis delta virus infection.
Figure 2
Figure 2
Typical serologic pattern of coinfection by hepatitis B virus and hepatitis delta virus. The ALT peak is characterised by a double phase being the first due to HBV replication and the second to HDV replication. IgM anti-HDV appear quickly, followed by seroconversion to IgG anti-HD. HBV infection in this phase is revealed by the presence of IgM anti-HBc and HBV viremia. The self-limiting coinfection is transient and persistence of serum IgG anti-HD is the only marker of past HDV infection. HDV: Hepatitis delta virus; HBV: Hepatitis B virus; HBsAg: Hepatitis B surface antigen; ALT: Alanine aminotransferases.
Figure 3
Figure 3
Typical serologic pattern of hepatitis delta virus superinfection: Severe acute hepatitis is characterised by alanine aminotransferases elevation that follows the peak of hepatitis delta virus viremia and is coincidental with IgM anti-HD rise. Markers of HBV infection are usually inhibited. IgM anti-HBc and HBV DNA typically test negative. HDV: Hepatitis delta virus; HBsAg: Hepatitis B surface antigen; ALT: Alanine aminotransferases.
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