- Aka, “Delta agent”
- Negative-sense RNA Deltavirus with an enveloped icosahedral capsid.
“Defective” virus*
– Relies on components of its helper virus,
Hepatitis B, for replication in the host.
– Derives envelope from HBsAg
- Increases severity of Hepatitis B infection.
- Transmitted in blood, tissue, and semen
- Patients can enter a carrier state.
- Clinical course
Depends on its timing in relation to Hepatitis B infection:
–
HBV co-infection occurs when the two viruses are contracted at the
same time.
–
HBV superinfection occurs when Hepatitis D is contracted
after Hepatitis B has already established infection.
– In both cases,
Hepatitis D exacerbates the symptoms of Hepatitis B infection.
– Symptoms can be
mild to severe, and can include
fulminant hepatitis.
Fulminant hepatitis is characterized by encephalopathy and hepatic necrosis, and is often fatal.
–
Superinfection is more often associated with severe outcomes.
- Hepatitis B co-infection has a slow onset.
– This is because Hepatitis D cannot replicate until its helper virus has established infection and made its components available for use.
- Hepatitis B superinfection onset occurs rapidly because the necessary components of Hepatitis B are readily available to Hepatitis D.
- Serological Values
– HDV RNA
- Vaccination against Hepatitis B robs Hepatitis D of its helper virus.
- Infected patients may be given interferon treatments.
Hepatitis A
Hepatitis B
Hepatitis C
Hepatitis E
Abbas, Zaigham, and Rafia Afzal. “Life Cycle and Pathogenesis of Hepatitis D Virus: A Review.” World Journal of Hepatology 5, no. 12 (December 27, 2013): 666–75. https://doi.org/10.4254/wjh.v5.i12.666.
Farci, Patrizia, and Grazia Niro. “Clinical Features of Hepatitis D.” Seminars in Liver Disease 32, no. 03 (August 2012): 228–36. https://doi.org/10.1055/s-0032-1323628.
Kasper, Dennis L., Stephen Hauser L., Larry Jameson J., Anthony S. Fauci, Dan Longo L., and Joseph Loscalzo. Harrison’s Principles of Internal Medicine. 19th ed. McGraw-Hill Education, 2015.
Levinson, W. Review of Medical Microbiology & Immunology. 14th ed. McGraw-Hill Education, 2016.
Noureddin, Mazen, and Robert Gish. “Hepatitis Delta: Epidemiology, Diagnosis and Management 36 Years After Discovery.” Current Gastroenterology Reports 16, no. 1 (2014). https://doi.org/10.1007/s11894-013-0365-x.
“WHO | What Is Hepatitis?” WHO. Accessed August 29, 2018. http://www.who.int/features/qa/76/en/.
