Hepatitis D laboratory findings

Hepatitis Main Page
Hepatitis D
Home
Patient Information
Overview
Historical Perspective
Pathophysiology
Causes
Differentiating Hepatitis D from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
History and Symptoms
Physical Examination
Laboratory Findings
CT
MRI
Ultrasound
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Hepatitis D laboratory findings On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Hepatitis D laboratory findings All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Hepatitis D laboratory findings
CDC on Hepatitis D laboratory findings
Hepatitis D laboratory findings in the news
Blogs on Hepatitis D laboratory findings
Directions to Hospitals Treating Hepatitis D
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]

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.

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.

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 Treatment Options for Hepatitis Delta Virus Infection - Springer Science