Diagnosis of hepatitis D virus infection

  • Edouard Kurstak


The diagnosis of hepatitis D virus infection or delta hepatitis is often difficult and the serological assay commercially available and in use is the radio-immunoassay for anti-HDV. Anti-HDV detected by immunoassay, however, frequently appears late in the disease and is transient and, as such, any accurate diagnosis entails the testing of paired serum specimens from the acute phase as well as convalescence. Testing for IgM to hepatitis B core antigen, the serological marker of acute hepatitis B, provides a method for distinguishing a coinfection from superinfection in cases of acute hepatitis D. A correct etiologic diagnosis can however be only made by testing acute phase sera for all the available markers of HDV. In fact, it has been suggested that the best cost-effective procedure may be to test any patient with HBV markers at presentation for anti-HD, 30–40 days after the onset of symptoms (Salassa et al., 1991).


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  1. Aceti A, Papro BS, Celestino D, Pennica A, Caferro M, Brilli A, Sebastiani A, Muhamud OM, Abdirahman M, Bite K (1989) Trans R Soc Trop Med Hyg 83: 399–400PubMedCrossRefGoogle Scholar
  2. Amazigo UO, Chime A (1988) Trans R Soc Trop Med Hyg 82: 907PubMedCrossRefGoogle Scholar
  3. Andrade ZA, Santos JB, Prata A, Dourado H (1983) Rev Soc Brasil Med Trop 16: 31–40CrossRefGoogle Scholar
  4. Aragona M, Caredda F, Lavarini C, Farci P, Macagno S, Crivelli O, Maran E, Purcell RH, Rizzetto M (1987) Lancet 1: 478–480PubMedCrossRefGoogle Scholar
  5. Ashraf SJ, Arya SC, Arendrup M, Krogsgaard K, Parande CM, Orskov B, Ageel AR (1986) Liver 6: 73–77PubMedCrossRefGoogle Scholar
  6. Bergmann KF, Gerin JL (1986) J Infect Dis 154: 702–706PubMedCrossRefGoogle Scholar
  7. Bonino F, Hoyer B, Ford E, Shih HWK, Purcell RH, Gerin JL (1981) Hepatology 1: 127–131PubMedCrossRefGoogle Scholar
  8. Bonino F, Hoyer B, Shih JWK, Rizzetto M, Purcell RH, Gerin JL (1984) Infect Immunol 43: 1000–1005Google Scholar
  9. Bonino F, Caporaso N, Dentico P, Marinucci G, Valeri L, Craxi A, Ascione A, Raimondo G, Picciaino F, Rocca G, Rizzetto M (1985) J Hepatol 1: 221–226PubMedCrossRefGoogle Scholar
  10. Bonino F, Herman KH, Rizzetto M, Gerlich WH (1986) J Virol 58: 945–950PubMedCentralPubMedGoogle Scholar
  11. Bonino F, Smedile A (1986) Semin Liver Dis 6: 28–33PubMedCrossRefGoogle Scholar
  12. Butrago B, Popper H, Hadler SC, T Hung SN, Gerber MA, Purcel R, Maynard JE (1986) Hepatology 6: 1285–1291CrossRefGoogle Scholar
  13. Caredda F, Rossi E, D’Armino Monforte A, Zampini L, Re T, Meruni B, Moroni M (1985) J Infect Dis 151: 925–928PubMedCrossRefGoogle Scholar
  14. Caredda F, Antinori S, Re T, Pastecchia C, Moroni M (1987) Prog Clin Biol Res 234: pp 267–276PubMedGoogle Scholar
  15. Cariani E, Ravaggi A, Puoti M, Mantero G, Albertini A, Primi D (1992) Hepatology 15: 685–689PubMedCrossRefGoogle Scholar
  16. Chao YC, Lee CM, Tang HS, Govindarajan S, Lai MMC (1991) Hepatology 13: 345–352PubMedGoogle Scholar
  17. Craxi A, Raimondo G, Pasqua P, Giannoli G, DiFranco C, Pagliaro L (1984) Fron Gastroent Res 8: 191–196Google Scholar
  18. De Cock KM, Govindarajan S, Redeker AG (1987) Prog Clin Biol Res 234: 167–179PubMedGoogle Scholar
  19. Denniston KJ, Hayer BH, Smedile A, Wells FV, Nelson J, Gerin JL (1986) Science 232: 873–875PubMedCrossRefGoogle Scholar
  20. Dimitrakakis M, Waters MJ, Woolten A, Gust ID (1986) J Med Virol 20: 308–311CrossRefGoogle Scholar
  21. Dinter-Gottlieb G (1986) Proc Natl Acad USA 83: 6250–6254CrossRefGoogle Scholar
  22. DiSapio M, Caporaso N, Vecchio-Blanco CD, Coltorte M (1988) Liver 8: 236–240Google Scholar
  23. Dourakis S, Karayiannis P, Goldin R, Taylor M, Monjardino S, Thomas HC (1991) Hepatology 14: 534–539PubMedGoogle Scholar
  24. Dubois F, Goudeau A (1988) J Clin Microbiol 26: 1338–1342Google Scholar
  25. Farci P, Aragona M, Crivello O (1986) JAMA 255: 1443–1446PubMedCrossRefGoogle Scholar
  26. Fattovich G, Boscaro S, Noventa F, Pornaro E, Stenico D, Alberti A, Ruol A, Realdi G (1987) J Infect Dis 155: 931–935PubMedCrossRefGoogle Scholar
  27. Gmelin K, Roggendorf M, Schlipkoter U, Theilmann L, Bommer J, Kommerell B, Deinhardt F (1985) J Infect Dis 151: 374PubMedCrossRefGoogle Scholar
  28. Govindarajan S, Lin B, Peters RL (1984) Histopathology 8: 63–67PubMedCrossRefGoogle Scholar
  29. Govindarajan S, Valinluck B, Peters RL (1986) Gut 27: 19–22PubMedCentralPubMedCrossRefGoogle Scholar
  30. Govindarajan S, Cassidy WM, Valinluck B, Redeker AG (1991) Prog Clin Biol Res 364: 207–210PubMedGoogle Scholar
  31. Greenfield C, Farci P, Orisna V, McPherson CN, Romig T, Zeyhie E, French M, Johnson B, Tukei P, Winkays BM, Thomas HC (1986) Am J Epidemiol 123: 416–423PubMedGoogle Scholar
  32. Gupta S, Valinluck B, Govindarajan S (1989) Am J Clin Pathol 92(2): 218–221PubMedGoogle Scholar
  33. Gupta S, Govindarajan S, Cassidy WM, Valinluck B, Redeker AG (1991) Am J Gastroenterol 86: 1227–1231PubMedGoogle Scholar
  34. Hadler SC, deMonzon M, Ponzetto A, Anzolia E, Rivera D, Mondolfi A, Bracho A, Francis DP, Gerber MA, Thung S, Gerin JL, Maynard JE, Popper H, Purcell RH (1984) Ann Intern Med 109: 339–344CrossRefGoogle Scholar
  35. Hedin G, Weiland O, Ljunggren K, Strombert A, Nordenfelt E, Hannson BG, Oberg B (1987) In: Progress in clinical and biological research, vol 234. Rizzetto M, Gerin JL, Purcell RH (eds) Alan R Liss, New York, pp 309–320Google Scholar
  36. Hedin G, Weiland O, Ljunggren K, Nordeenfelt E, Hansson BG, Lernestedt JO, Oberg B (1988) In: Zuckerman AJ (ed) Viral hepatitis and liver disease. Alan R Liss, New York, pp 947–952Google Scholar
  37. Heijtink R, Kruining J, Krupers L, Jacobs A, Geudens C, Walters G (1983) In: Verme G, Bonino F, Rizzetto M (eds) Viral hepatitis and liver disease. Alan R Liss, New York, pp 263–272Google Scholar
  38. Hoofnagle JH, Mullen K, Peters M, Avigan M, Park Y, Waggoner J, Gerin JL, Hayer B, Smedile A (1987) In: Rizzetto M, Gerin JL, Purcell RH (eds) Progress in clinical and biological research, vol 234. Alan R Liss, New York, pp 291–298Google Scholar
  39. Hoofnagle JH (1989) JAMA 261: 1321–1325PubMedCrossRefGoogle Scholar
  40. Jacobson DM, Dienstag JL, Werner BG, Brettler DB, Levine PH, Mushahwar DR (1986) Hepatology 5: 188–191CrossRefGoogle Scholar
  41. Jardi R, Buti M, Rodriguez-Frias F, Garcia-Lafuente A, Sjogren MH, Esteban R, Guardia J (1991) Hepatology 14: 25–28PubMedCrossRefGoogle Scholar
  42. Kos A, Dijkema R, Arnberg AC, Van des Meids PH, Schellekens H (1986) Nature 323: 558–560PubMedCrossRefGoogle Scholar
  43. Liaw YF, Chiu KW, Chu CM, Sheen IS, Huang MJ (1990) J Infect Dis 162: 1170–1172PubMedCrossRefGoogle Scholar
  44. Lattau LA, McCarthy JG, Smith MH (1987) N Engl J Med 317: 1256–1262CrossRefGoogle Scholar
  45. Madejon A, Castillo I, Bartolome J, Melero M, Campillo ML, Porres JC, Moreno A, Carreno V (1991) J Hepatol 11: 381–384CrossRefGoogle Scholar
  46. Makino S, Chang MF, Shieh CK, Kamahora T, Vannier DM, Govindarajan S, Lai MMC (1987) Nature 329: 343–346PubMedCrossRefGoogle Scholar
  47. Maestrup T, Hansson BG, Widell A, Nordenfelt F (1983) Br Med J 286: 87–90CrossRefGoogle Scholar
  48. Matthyssen L, Skystra M, Nelissen P, Werff, Walters G (1988) In: Zuckerman AJ (ed) Viral hepatitis and liver disease. Alan R Liss, New York, pp 408–411Google Scholar
  49. Nordenfelt E, Hannsson BG, Al-Nakib B (1983) J Infect Dis 148-168Google Scholar
  50. Pol S, Dubois F, Roingeard P, Zignedo L, Housset C, Bréchot C, Goudeau A, Berthelot P (1989) Hepatology 10: 342–345PubMedCrossRefGoogle Scholar
  51. Ponzetto A, Forzani B, Puravicini PP, Hele C, Rizzetto M, Zenetti A (1985) Eur Epidemiol 1: 257–263Google Scholar
  52. Price JS, France AJ, Maoven LD, Welsby PD (1986) Lancet 1: 1273CrossRefGoogle Scholar
  53. Raimondo G, Smedile A, Gallo L (1982) Lancet 1: 249–251PubMedCrossRefGoogle Scholar
  54. Rasshafler R, Buti M, Esteban R, Jandi R, Roggendorf M (1988) J Infect Dis 157: 191–195CrossRefGoogle Scholar
  55. Rizzetto M, Canese MG, Arico S, Crivelli O, Trepo CG, Bonino F, Verme G (1977) Gut 18: 997–1003PubMedCentralPubMedCrossRefGoogle Scholar
  56. Rizzetto M, Canese MG, Gerin JL, London WT, Sly DL, Purcell RH (1980) J Infect Dis 121: 590–602CrossRefGoogle Scholar
  57. Rizzetto M, Morello C, Marinucie PM (1982) J Infect Dis 145: 18–22PubMedCrossRefGoogle Scholar
  58. Rizzetto M, Verme G, Recchia S (1983) Ann Intern Med 98: 437–441PubMedCrossRefGoogle Scholar
  59. Rizzetto M (1984) Hepatology 3: 729–737CrossRefGoogle Scholar
  60. Rizzetto M, Verme G, Gerin JL, Purcell RH (1986) In: Schaffner F (ed) Progress liver disease VIII. Grune & Stratton, New York, pp 417–431Google Scholar
  61. Rizzetto M, Macagno S, Chiaberge F, Verme G, Negre P, Marinucci G, DiGiacommo G, Alfani D, Cortesini R, Milazzo F, Dogina M, Fassati R, Galmorini (1987) Lancet 2: 469–471PubMedCrossRefGoogle Scholar
  62. Rizzetto M, Ponzetto A, Bonino F, Smedile A (1988) In: Zuckerman AJ (ed) Viral hepatitis and liver disease. Alan R Liss, New York, pp 389–394Google Scholar
  63. Salassa B, Daziano E, Bonino F, Lavanni C, Smedile A, Chiaberge E, Rosina F, Brunetto MR, Pessione E, Spezia C (1991) J Hepatol 12: 10–13PubMedCrossRefGoogle Scholar
  64. Saldanha J, Thomas HC, Monjardino J (1987) J Med Virol 2104: 35A Abstract 102Google Scholar
  65. Saldanha J, Thomas HC, Monjardino J (1988) In: Zuckerman AJ (ed) Viral hepatitis and liver disease. Alan R Liss, New York, pp 198–199Google Scholar
  66. Shattock AG, Irwin FM, Morgan BM, Hillary IB, Kelly MG, Feilding JF, Kelly DA, Weir DG (1985) Br Med J 290: 1377–1380CrossRefGoogle Scholar
  67. Shattock AG (1989) J Virol Methods 23: 233–238PubMedCrossRefGoogle Scholar
  68. Shattock AG, Morris MC (1991) J Clin Microbiol 29(9): 1873–1876PubMedCentralPubMedGoogle Scholar
  69. Smedile A, Dentien P, Zanetti A, Sagnelli E, Nordenfelt E, Acs G, Rizzetto M (1981) Gastroen-terology 81: 992–997Google Scholar
  70. Smedile A, Lavarini C, Crivelli O, Raimondo G, Fassone M, Rizzetto M (1982) J Med Virol 9: 131–138PubMedCrossRefGoogle Scholar
  71. Smedile A, Locarnini C, Farci P (1983) Am J Epidemiol 117: 223–229PubMedGoogle Scholar
  72. Smedile A, Rizzetto M, Denniston K, Bonino F, Wells F, Verme G, Consolo F, Hayer B, Purcell RH, Gerin JL (1986) Hepatology 6: 1297–1302PubMedCrossRefGoogle Scholar
  73. Smedile A, Baraudy BM, Bergman KF, Rizzetto M, Purcell RH, Gerin JL (1987) In: Rizzetto M, Gerin JL, Purcell RH (eds) Progress in clinical and biological research, vol 234. Alan R Liss, New York, pp 235–241Google Scholar
  74. Smedile A, Rosina F, Saracco G, Chiaberge E, Lattore V, Fahiano A, Brunetto MR, Verme G, Rizzetto M, Ronino F (1991a) Hepatology 13(3): 413–416PubMedCrossRefGoogle Scholar
  75. Smedile A, Rosina F, Chiaberge E, Lattone V, Saracco G, Brunetto MR, Bonino F, Verma G, Rizzetto M (1991b) Prog Clin Biol Res 364: 185–195PubMedGoogle Scholar
  76. Thomas HC, Farci P, Karayiannis P, Smedile A, Caroso L, Gerin JL (1987) In: Rizzetto M, Gerin JL, Purcell RH (eds) Progress in clinical and biological research, vol 234. Alan R Liss, New York, pp 277–290Google Scholar
  77. Tsega E, Mengesha B, Hansson BG, Lindsberg J, Nordenfelt E (1986) Am J Epidemiol 123: 344–351PubMedGoogle Scholar
  78. Verme G, Brunetto MR, Oliveri F, Baldi M, Forzani B, Piantino P, Ponzetto A, Bonino F (1991) Dig Dis Sci 36: 1134–1136PubMedCrossRefGoogle Scholar
  79. Wang KS, Choo QL, Weiner AJ, Ou SH, Najarian RC, Thayer RM, Mullenbach GT, Denniston KJ, Gerin JL, Houghton M (1986) Nature 323: 508–513PubMedCrossRefGoogle Scholar
  80. Wong DT, Nath N, Sninsky JJ (1985) J Virol 55: 223–231PubMedCentralPubMedGoogle Scholar
  81. Wu HNt Lai MMC (1989) Science 243: 652–654CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Wien 1993

Authors and Affiliations

  • Edouard Kurstak
    • 1
    • 2
    • 3
  1. 1.Department of Microbiology and ImmunologyUniversity of MontrealCanada
  2. 2.World Health OrganizationGenevaSwitzerland
  3. 3.King Fahad National Guard HospitalRiyadhSaudi Arabia

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