Delta Hepatitis and the Hepatitis Delta Virus

  • Jay H. Hoofnagle


Since its discovery in 1977 by Rizzetto and co-workers from Turin, Italy, the hepatitis delta virus (HDV) has become a focus of worldwide interest—interest almost equal to its worldwide importance.1, 2 The delta antigen, which first appeared to be a poorly explained finding of immunofluorescence staining in liver biopsies from Italian chronic hepatitis S surface antigen (HBsAg) carriers, has now been shown to be the nucleocapsid antigen of a startlingly unique and important viral agent. HDV is a “defective” RNA virus that can replicate only in the presence of HBsAg, the helper function provided by hepatitis S virus (HBV). For this reason, delta hepatitis occurs only in patients who have HBsAg in serum. Acute delta hepatitis occurs either as co-infection, simultaneous with acute hepatitis B, or as superinfection, in which acute delta hepatitis is superimposed on a chronic hepatitis S or an HBsAg carrier state. Delta superinfection commonly leads to chronic delta hepatitis, which ultimately leads to cirrhosis in more than 50% of cases.3 Delta hepatitis also has a peculiar epidemiology, commonly occurring in prolonged severe outbreaks in isolated communities.4 Delta hepatitis is most likely an old disease; indeed, the fulminant hepatitis syndromes known as Labrea fever and the hepatitis of Sierra Nevada de Santa Marta, described in South America for the past 50 years, probably present severe forms of acute delta hepatitis.5 This chapter summarizes recent advances made in the understanding of delta hepatitis and HDV.


Hepatitis Delta Virus Helper Virus HBsAg Carrier Hepatitis Delta Virus Infection Delta Antigen 
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Copyright information

© Plenum Publishing Corporation 1989

Authors and Affiliations

  • Jay H. Hoofnagle
    • 1
  1. 1.Liver Diseases Section, Digestive Diseases Branch, National Institute of Diabetes and Digestive and Kidney DiseasesNational Institutes of HealthBethesdaUSA

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