Acute HBV/HDV Infection

  • Cihan YurdaydinEmail author


HDV infection represents the rarest form of viral hepatitis in humans and acute infection today represents the very rare form of this rare infection. Three forms of acute hepatitis may be differentiated: acute hepatitis secondary to HBV/HDV co-infection; supeinfection of an HBsAg carrier leads to chronic active hepatitis in 90% of patients but the early superinfection period may lead to an acute hepatitis like picture; finally, recurrence of HDV after liver transplantation may lead to acute HDV hepatitis. Clinical course of acute HBV/HDV disease is similar to the clinical course of other forms of acute viral hepatitis. Thus the clinical presentation may range from mild hepatitis to fulminant hepatitis. In general, a more severe course is reported in the setting of acute HBV/HDV infection. Fulminant hepatitis has been more frequently asssociated with HDV although such cases are less frequently observed today. A biphasic hepatitic peak due to HBV and HDV, respectively, is sometimes observed. First markers of the infection are the presence of HBsAg with HBV and HDV viremia. Serum HDAg is measured commercially with an enzyme-linked immunosorbent assay (ELISA) or a radioimmunoassay (RIA) and is detectable only for a short period. In acute HBV/HDV infection, anti-HBc IgM becomes present in high titers, is transient, and disappears after infection subsides. In HDV superinfection of an HBsAg carrier, anti-HBcIgM is either not detectable or if present only detectable in low titers. Anti-HDV IgM may develop late in the course of acute infection. It will gradually disappear after the acute infection. Anti-HDV IgG’s appearance in serum follows anti-HDV IgM but appears somewhat later. After resolution of the infection it will remain detectable long term. No therapo of proven benefit for acute HBV/HDV co-infection exists but new treatment approaches may become available soon.


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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of GastroenterologyAnkara University Medical SchoolAnkaraTurkey

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