Hepatitis D laboratory findings: Difference between revisions

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Revision as of 23:32, 6 August 2014

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Varun Kumar, M.B.B.S. [2]

Laboratory Findings

The table below describes the significance of diagnostic markers in HDV infection. ^[1]


Diagnostic Markers	Significance
Anti-HDV IgG antibody	Positive in persons exposed to HDV Persists, even after viral clearance
Anti-HDV IgM antibody	Positive in acute infection Negative in past infection Persists in many patients with chronic infection
HDV RNA	Qualitative Marker of HDV replication Positive in chronic infection Negative in spontaneous or treatment-induced viral clearance Quantitative Useful in monitoring or predicting treatment response
HBsAg	Qualitative Must be positive for HDV infectivity Quantitative Positively correlated with HDV RNA Falling titer signals HBsAg loss, and hence HDV clearance Useful in monitoring or predicting treatment response
HBeAg	Negative in an estimated 85% of patients Associated with detectable anti-HBe
HBV DNA	Quantitative Suppressed by HDV Negative or low levels in most patients May be increased in patients with detectable HBeAg Can reactivate after spontaneous or treatment-induced clearance of HDV
ALT	Increased in most patients Does not correlate well with degree of histological liver damage

References

↑ Hughes SA, Wedemeyer H, Harrison PM (2011). "Hepatitis delta virus". Lancet. 378 (9785): 73–85. doi:10.1016/S0140-6736(10)61931-9. PMID 21511329.

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[pmid21511329-1] Hughes SA, Wedemeyer H, Harrison PM (2011). "Hepatitis delta virus". Lancet. 378 (9785): 73–85. doi:10.1016/S0140-6736(10)61931-9. PMID 21511329.

[1]

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-Anti-HDV antibodies are present in all persons infected with HDV. All patients positive for HBsAg should be tested for anti-HDV IgG antibodies. Active HDV infection is confirmed by the detection of serum HDV RNA with sensitive real-time PCR assay.
-Every person that is positive for HBsAg should be tested for anti-HDV IgG antibodies at least once.
-There is no evidence that direct testing for HDV RNA in the absence of anti-HDV antibodies is of any use because anti-HDV antibodies develop in everyone infected with HDV.
-*Detection of HDV RNA using reverse transcriptase polymerase chain reaction assay has a high sensitivity in detection of HDV [[viremia]].
-*HDV antigen may be detected.
-*Levels of anti-delta agent antibodies such as [[IgM]] and [[IgG]] are generally be elevated. Detection of [[IgA]] antibodies to HDV is exclusively associated with chronic HDV infection.<ref name="pmid1959886">{{cite journal |author=McFarlane IG, Chaggar K, Davies SE, Smith HM, Alexander GJ, Williams R |title=IgA class antibodies to hepatitis delta virus antigen in acute and chronic hepatitis delta virus infections |journal=[[Hepatology (Baltimore, Md.)]] |volume=14 |issue=6 |pages=980–4 |year=1991 |month=December |pmid=1959886 |doi= |url= |accessdate=2012-03-16}}</ref>
-*Patients may also be positive for [[HBsAg]] and anti-HB core IgM. However HBsAg levels may be suppressed to undetectable levels with active HDV replication.
-*Liver function tests may generally show elevated serum [[alanine aminotransferase]] and [[aspartate aminotransferase]] levels.
-*Elevated international normalized ratio ([[INR]]) with prolongation of [[prothrombin time]] suggests fulminant [[hepatic failure]].
 ==References==

Hepatitis D laboratory findings: Difference between revisions

Revision as of 23:32, 6 August 2014

Laboratory Findings

References

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