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Hepatitis D Virus Infection: Role of Hepatitis B and the Current Updates on Management

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Abstract

Hepatitis D virus (HDV) discovery was linked to hepatitis B virus (HBV), where it was named as delta antigen and thereafter found to be the smallest RNA virus but a genome by itself depending of hepatitis B in its life cycle. It uses hepatitis B surface antigen as envelope and uses similar mechanism to enter the hepatocyte. Once inside the hepatocyte, it uses the host cell enzymes to replicate. HDV has eight genotypes with variation in geographic location and clinical severity. Also, certain HBV genotypes are linked with higher viral load and lower remission rates. Chronic hepatitis D (CHD) can result from either coinfection or superinfection of HBV, the latter associated with higher rate of progression to CHD. Pegylated interferon has been the mainstay treatment for CHD for many years with discouraging virological response around 25%. Recent trails of new medications including myrcludex B, lonafarnib, and nucleic acid polymers show some promising results awaiting further larger trials.

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Albarrak, A.A., Tran, KD., Tahan, V. (2018). Hepatitis D Virus Infection: Role of Hepatitis B and the Current Updates on Management. In: Ozaras, R., Tahan, V. (eds) Viral Hepatitis: Chronic Hepatitis B. Springer, Cham. https://doi.org/10.1007/978-3-319-93449-5_8

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