Hepatitis D (Delta)
Hep D diagnosis and management for doctors, medical students, finals and MRCP PACES
Definition of Hepatitis D
- A subviral satellite which can only propagate in the presence of the HBV virus
Epidemiology of Hepatitis D
- Prevalent in same areas as hepatitis B
Causes of Hepatitis D
- Small circular RNA virus
- Occurs either as a simultaneous infection with HBV (coinfection) or superimposed on chronic HBV infection (superinfection)
Presentations of Hepatitis D
- Patients develop complications of chronic liver disease more rapidly when co/superinfected with HBV and HDV
- Increased likelihood of liver failure, HCC and cirrhosis
Diagnosis of hepatitis D
- HDV antigens and HDV RNA levels
Initial management of Hepatitis D
- See management of HBV
- Peg-interferon is the only treatment for chronic hepatitis delta
Complications of hepatitis D
- Chronic liver disease with all its associated complications
Prognosis of Hepatitis D
- Chronic hepatitis delta carries the highest mortality of all the hepatitis viruses
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