A review on epidemiology, diagnosis and treatment of hepatitis D virus infection

Hepatitis D Virus (HDV) infection is a widespread disease that has affected a large number of population with hepatitis B Virus (HBV) infection in Iran. Disease is considered to be a major public health problem in Iran. Delta hepatitis is the least common form of chronic viral hepatitis and is the form most likely to lead to cirrhosis. Delta hepatitis is serologically complex, so effective therapy is difficult. The diagnosis is made on the basis of the presence of antibodies against HDV (anti-HDV) and hepatitis B surface antigen (HBsAg) in the serum of a patient with chronic liver disease. It is confirmed by the presence of the HDV antigen in liver or HDV RNA in the serum (by reverse-transcriptionpolymerase-chain-reaction assay). It is important to determine whether delta hepatitis is present because the responses to therapy of patients with this disease are less satisfactory than those with hepatitis B, and the recommended regimen of interferon alfa is different. The optimal treatment of HDV is uncertain. Thus, patients should ideally be treated as part of a clinical trial. The only treatment approved for chronic HDV is interferon alfa. Treatment should be administered for one year; whether longer duration of treatment will improve response rates remains to be established. Available data have not demonstrated an advantage from the addition of a nucleos/tide analogue.