Hepatitis D laboratory findings: Difference between revisions
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[[Hepatitis D]] should be considered in any individual who is [[HBsAg]] positive or that has evidence of recent [[HBV infection]]. The [[diagnosis]] of acute [[hepatitis D]] is made after evaluation of [[serologic]] tests for the [[HDV|virus]]. Persons infected with [[HDV]] develop anti-HDV antibodies. Accordingly, every individual with an [[HBsAg]] positive test result, should be studied for the presence of anti-HDV [[IgG]] antibodies.<ref name="pmid21511329">{{cite journal| author=Hughes SA, Wedemeyer H, Harrison PM| title=Hepatitis delta virus. | journal=Lancet | year= 2011 | volume= 378 | issue= 9785 | pages= 73-85 | pmid=21511329 | doi=10.1016/S0140-6736(10)61931-9 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21511329 }} </ref> | [[Hepatitis D]] should be considered in any individual who is [[HBsAg]] positive or that has evidence of recent [[HBV infection]]. The [[diagnosis]] of acute [[hepatitis D]] is made after evaluation of [[serologic]] tests for the [[HDV|virus]]. Persons infected with [[HDV]] develop anti-HDV antibodies. Accordingly, every individual with an [[HBsAg]] positive test result, should be studied for the presence of anti-HDV [[IgG]] antibodies.<ref name="pmid21511329">{{cite journal| author=Hughes SA, Wedemeyer H, Harrison PM| title=Hepatitis delta virus. | journal=Lancet | year= 2011 | volume= 378 | issue= 9785 | pages= 73-85 | pmid=21511329 | doi=10.1016/S0140-6736(10)61931-9 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21511329 }} </ref> | ||
The active form of the [[HDV infection]] was initially diagnosed by the detection of anti-HDV [[IgM]] antibodies. However, today the acute [[infection]] is confirmed with [[real-time PCR]], by detecting [[serum]] [[HDV]] [[RNA]].<ref name="pmid20351206">{{cite journal| author=Mederacke I, Bremer B, Heidrich B, Kirschner J, Deterding K, Bock T et al.| title=Establishment of a novel quantitative hepatitis D virus (HDV) RNA assay using the Cobas TaqMan platform to study HDV RNA kinetics. | journal=J Clin Microbiol | year= 2010 | volume= 48 | issue= 6 | pages= 2022-9 | pmid=20351206 | doi=10.1128/JCM.00084-10 | pmc=PMC2884474 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20351206 }} </ref> | The active form of the [[HDV infection]] was initially diagnosed by the detection of anti-HDV [[IgM]] antibodies. However, today the acute [[infection]] is confirmed with [[real-time PCR]], by detecting [[serum]] [[HDV]] [[RNA]].<ref name="pmid20351206">{{cite journal| author=Mederacke I, Bremer B, Heidrich B, Kirschner J, Deterding K, Bock T et al.| title=Establishment of a novel quantitative hepatitis D virus (HDV) RNA assay using the Cobas TaqMan platform to study HDV RNA kinetics. | journal=J Clin Microbiol | year= 2010 | volume= 48 | issue= 6 | pages= 2022-9 | pmid=20351206 | doi=10.1128/JCM.00084-10 | pmc=PMC2884474 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20351206 }} </ref> | ||
Patients presenting with [[liver disease]], following [[HDV infection]], should be tested for anti-HDV [[IgM]] antibodies, even when the [[HDV]] [[RNA]] test is negative. This is due to the fact that the [[hepatitis D virus]] shows [[genome]] variability, which might lead to false-negative results.<ref name="pmid17591028">{{cite journal| author=Manesis EK, Schina M, Le Gal F, Agelopoulou O, Papaioannou C, Kalligeros C et al.| title=Quantitative analysis of hepatitis D virus RNA and hepatitis B surface antigen serum levels in chronic delta hepatitis improves treatment monitoring. | journal=Antivir Ther | year= 2007 | volume= 12 | issue= 3 | pages= 381-8 | pmid=17591028 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17591028 }} </ref><ref name="pmid15872267">{{cite journal| author=Le Gal F, Gordien E, Affolabi D, Hanslik T, Alloui C, Dény P et al.| title=Quantification of hepatitis delta virus RNA in serum by consensus real-time PCR indicates different patterns of virological response to interferon therapy in chronically infected patients. | journal=J Clin Microbiol | year= 2005 | volume= 43 | issue= 5 | pages= 2363-9 | pmid=15872267 | doi=10.1128/JCM.43.5.2363-2369.2005 | pmc=PMC1153793 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15872267 }} </ref> Although the levels of [[HDV]] RNA in the serum do not correlate with the stage of the disease, or [[liver]] [[fibrosis]], the HDV RNA quantification may be used to evaluate the response to the [[antiviral]] therapy. | |||
Revision as of 02:08, 8 August 2014
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Hepatitis D |
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Diagnosis |
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Treatment |
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Hepatitis D laboratory findings On the Web |
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American Roentgen Ray Society Images of Hepatitis D laboratory findings |
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Risk calculators and risk factors for Hepatitis D laboratory findings |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Jolanta Marszalek, M.D. [2] João André Alves Silva, M.D. [3]
Overview
Laboratory Findings
Hepatitis D should be considered in any individual who is HBsAg positive or that has evidence of recent HBV infection. The diagnosis of acute hepatitis D is made after evaluation of serologic tests for the virus. Persons infected with HDV develop anti-HDV antibodies. Accordingly, every individual with an HBsAg positive test result, should be studied for the presence of anti-HDV IgG antibodies.[1]
The active form of the HDV infection was initially diagnosed by the detection of anti-HDV IgM antibodies. However, today the acute infection is confirmed with real-time PCR, by detecting serum HDV RNA.[2]
Patients presenting with liver disease, following HDV infection, should be tested for anti-HDV IgM antibodies, even when the HDV RNA test is negative. This is due to the fact that the hepatitis D virus shows genome variability, which might lead to false-negative results.[3][4] Although the levels of HDV RNA in the serum do not correlate with the stage of the disease, or liver fibrosis, the HDV RNA quantification may be used to evaluate the response to the antiviral therapy.
The table below describes the significance of diagnostic markers in HDV infection. [1]
| Diagnostic Markers | Significance |
|---|---|
| Anti-HDV IgG antibody |
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| Anti-HDV IgM antibody |
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| HDV RNA |
Qualitative
Quantitative
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| HBsAg |
Qualitative
Quantitative
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| HBeAg |
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| HBV DNA |
Quantitative
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| ALT |
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References
- ↑ 1.0 1.1 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.
- ↑ Mederacke I, Bremer B, Heidrich B, Kirschner J, Deterding K, Bock T; et al. (2010). "Establishment of a novel quantitative hepatitis D virus (HDV) RNA assay using the Cobas TaqMan platform to study HDV RNA kinetics". J Clin Microbiol. 48 (6): 2022–9. doi:10.1128/JCM.00084-10. PMC 2884474. PMID 20351206.
- ↑ Manesis EK, Schina M, Le Gal F, Agelopoulou O, Papaioannou C, Kalligeros C; et al. (2007). "Quantitative analysis of hepatitis D virus RNA and hepatitis B surface antigen serum levels in chronic delta hepatitis improves treatment monitoring". Antivir Ther. 12 (3): 381–8. PMID 17591028.
- ↑ Le Gal F, Gordien E, Affolabi D, Hanslik T, Alloui C, Dény P; et al. (2005). "Quantification of hepatitis delta virus RNA in serum by consensus real-time PCR indicates different patterns of virological response to interferon therapy in chronically infected patients". J Clin Microbiol. 43 (5): 2363–9. doi:10.1128/JCM.43.5.2363-2369.2005. PMC 1153793. PMID 15872267.
- ↑ Heidrich B, Manns MP, Wedemeyer H (2013). "Treatment options for hepatitis delta virus infection". Curr Infect Dis Rep. 15 (1): 31–8. doi:10.1007/s11908-012-0307-z. PMID 23242761.