[Hepatitis delta: Clinical aspects and therapeutic perspectives]

Area of Science:

• Hepatology
• Virology
• Infectious Diseases

Background:

• Hepatitis D virus (HDV) infection significantly exacerbates the severity of liver disease in individuals with chronic Hepatitis B virus (HBV) infection.
• HDV coinfection presents a substantial clinical challenge, necessitating specific diagnostic and management strategies beyond standard HBV care.

Purpose of the Study:

• To emphasize the importance of HDV screening in all HBV carriers.
• To outline current diagnostic approaches and treatment limitations for HDV infection.
• To highlight the necessity of long-term patient follow-up after treatment.

Main Methods:

• Diagnosis relies on detecting anti-HDV antibodies.
• Confirmation and quantification involve RT-qPCR for HDV RNA.
• Treatment currently utilizes pegylated alpha interferon.

Main Results:

• HDV infection is linked to more severe hepatic disease.
• Optimal treatment duration and relapse rates require further investigation.
• Sustained virologic response (SVR) does not preclude late viral relapses or fibrosis complications.

Conclusions:

• Universal HDV testing is recommended for all HBV carriers, especially those with worsening liver disease.
• Current treatment options are limited, with common relapses and unproven optimal durations.
• Lifelong monitoring is essential for detecting late relapses and managing potential complications like hepatocellular carcinoma (HCC).