Hepatitis D laboratory findings

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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.

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

Hepatitis D diagnosis Adapted from World Health Organization