Diagnosis and Treatment



Hepatitis D should be considered as a possibility in anyone who has evidence of HBV infection, especially if they have sever hepatitis B. The diagnosis of Hepatitis D is made on the basis of serologic tests for antibodies to the delta antigen. This test can be done by RIA or EIA. The Anti-D antibodies show up in the acute phase of both the superinfection and coinfection clinical patterns. Reverse transcription PCR is another possibility for detecting HDV virema PCR is the most sensitive method to diagnose HDV.



Unfortunately, there is no specific treatment for type D hepatitis. One treatment that was tried was immunosuppressive therapy but that was found to be ineffective. Low and moderate does of interferon-alpha has shown to have an inhibitory effect on HDV replication, but like interferon treatment for general HBV, the beneficial effects of the treatment were transitory. One recent study, by Lau et. al, showed that a very high dose of interferon given over 12 years can effectively cure someone with HDV/HBV infection. More study is needed in this area, however. As a last resort, orthotopic liver transplant has been relatively successful for treating fulminant acute and end-stage chronic hepatitis D. In fact there is evidence that liver transplant is more helpful in patients with HDV-HBV coinfection than in patients with just HBV.

"Ten Surgeons in Pink Transplant a Liver"  Xavier Cugat

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