82. Chronic viral hepatitis D

  1. C. J. Hawkey FMedSci3,
  2. Jaime Bosch MD, PhD4,5,
  3. Joel E. Richter MD, FACP, MACG6,7,
  4. Guadalupe Garcia-Tsao MD8,9 and
  5. Francis K. L. Chan MD10
  1. Patrizia Farci MD1 and
  2. Maria Eliana Lai MD2

Published Online: 16 APR 2012

DOI: 10.1002/9781118321386.ch82

Textbook of Clinical Gastroenterology and Hepatology, Second Edition

Textbook of Clinical Gastroenterology and Hepatology, Second Edition

How to Cite

Farci, P. and Lai, M. E. (2012) Chronic viral hepatitis D, in Textbook of Clinical Gastroenterology and Hepatology, Second Edition (eds C. J. Hawkey, J. Bosch, J. E. Richter, G. Garcia-Tsao and F. K. L. Chan), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781118321386.ch82

Editor Information

  1. 3

    Nottingham Digestive Diseases Centre, University of Nottingham and Nottingham University Hospitals, Nottingham, UK

  2. 4

    Hepatic Hemodynamic Laboratory, Liver Unit Hospital Clínic-IDIBAPS, University of Barcelona, Spain

  3. 5

    Biomedical Research Centre Network of Hepatic and Digestive Diseases (CIBERehd), National Institute of Health Carlos III Ministry of Science and Innovation Barcelona, Spain

  4. 6

    Division of Gastroenterology and Nutrition, University of South Florida Tampa, FL, USA

  5. 7

    Joy M. Culverhouse Center for Esophageal Diseases, University of South Florida Tampa, FL, USA

  6. 8

    Section of Digestive Diseases Yale University, School of Medicine New Haven, CT, USA

  7. 9

    Veterans Affairs Connecticut Healthcare System West Haven, CT, USA

  8. 10

    Department of Medicine & Therapeutics The Chinese University of Hong Kong, Hong Kong SAR, China

Author Information

  1. 1

    Hepatic Pathogenesis Section, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA

  2. 2

    Department of Medical Sciences, University of Cagliari, Policlinico Universitario, Monserrato, Cagliari, Italy

Publication History

  1. Published Online: 16 APR 2012
  2. Published Print: 20 APR 2012

ISBN Information

Print ISBN: 9781405191821

Online ISBN: 9781118321386



  • Hepatitis delta virus;
  • Chronic hepatitis D;
  • Epidemiology;
  • Natural history;
  • Clinical features;
  • Antibodies to HDV;
  • HDV RNA;
  • Treatment;
  • Standard interferon-α;
  • Pegylated interferon-α;
  • Prevention


Chronic hepatitis D is a disease caused by persistent infection with hepatitis D (delta) virus (HDV), a defective RNA virus that requires the helper function of hepatitis B virus (HBV). HDV is acquired by co-infection with HBV or by superinfection of an HBsAg carrier. Chronic hepatitis D almost invariably results from acute HDV superinfection of a chronic HBsAg carrier, which progresses to chronic hepatitis in over 90% of cases. HDV causes the least common but the most severe and rapidly progressive form of chronic hepatitis, leading to cirrhosis in 70–80% of the cases. Along with better control of HBV, there has been a significant decline in HDV in developed countries where the clinical scenario is now dominated by patients with long-standing infection manifested clinically as cirrhosis. However, immigration from endemic areas is posing a new threat for HDV resurgence in Europe. Interferon-α is the only approved therapy for chronic hepatitis D, but treatment remains unsatisfactory.