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> The HDV RNA quantification may be used to evaluate the response to the antiviral therapy. | ||
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. | 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> | ||
Revision as of 02:02, 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] The HDV RNA quantification may be used to evaluate the response to the antiviral therapy.
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]
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.