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Hepatitis D Virus

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Book cover Clinical Epidemiology of Chronic Liver Diseases

Abstract

Hepatitis D is caused by the hepatitis D virus (HDV), a ubiquitous RNA agent which depends upon the envelope proteins of the hepatitis B virus (HBV) for assembly of progeny virus. The infection is transmitted parenterally as well as sexually. Intravenous drug users are at the highest risk of infection. HBV infected patients who become superinfected with HDV are the major reservoir of the virus due to the high rate of chronicity. With the advent of universal HBV vaccination, the incidence of hepatitis D has declined in developed and developing countries. Residual disease persists in the aging domestic population of Southern Europe and in injection drug users and immigrants throughout Europe and the United States, with high concentrations in Mongolia and northwestern Amazonia as well as pockets of high-risk people in other countries. The prevalence of hepatitis D remains high and has a major medical impact in many areas of the developing world where HBV remains endemic and not controlled.

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Author information

Authors and Affiliations

  1. Division of Gastroenterology, University of Torino, Torino, Italy

    Mario Rizzetto

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  1. Mario Rizzetto
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Editor information

Editors and Affiliations

  1. Division of Gastroenterology and Hepatology, Alameda Health System Highland Hospital, Oakland, CA, USA

    Robert J. Wong

  2. Robert G. Gish Consultants LLC, Hepatitis B Foundation, Stanford Health Care, San Diego, CA, USA

    Robert G. Gish

Table of Landmark

Table of Landmark

Reference 6

Comprehensive summary of the knowledge on HDV, and of the prevalence and medical impact of Hepatitis D in the 1980s, when the epidemic of HDV was rampant throughout Southern Europe

Reference 7

Description of the structure of the HDV, its ribozyme and the unique replication strategy through a rolling circle mechanism unknown to human viruses

Reference 12

Classification of the genotypes of HDV; their geographical distribution and medical importance, their potential use in epidemiological analyses

Reference 16

Comprehensive summary of the distribution and prevalence of HDV in the world, derived from 35 years of epidemiological surveys since the discovery of the virus

Reference 20

Establishment of the First International Standard for HDV RNA; will provide the reference for a common molecular approach to diagnosis and monitoring of therapy

Reference 23

The first description of an outbreak of fulminant hepatitis D on the background of high HDV endemicity; a paradigm of other outbreaks that have ravaged poor countries in the third world

Reference 39

Recent recognition that Mongolia is the country with the highest prevalence of HDV in the world, corresponding with the highest incidence of Hepatocellular Carcinoma

Reference 61

Perception of the incipient decline of HDV in Europe in the 1990s; analysis of the factors influencing the decline

Reference 74

Current scenario of hepatitis D in Western Europe; impact of immigration in recapitulating the disease

Reference 77

Comprehensive review of the importance and ominous clinical role of HDV in patients with HIV infection

Reference 85

Raises awareness to the neglected problem of HDV in the US, urging consideration to more extensive testing for hepatitis D

Reference 91

Reports the discouraging results of efforts to develop a HDV vaccine and the reasons why it is difficult to reach immune protection

Given that majority of the landmark literature as it relates to HDV are narrative reviews without a significant amount of original research, the author of this chapter has provided the above take-home messages for key references in place of the landmark table format that is used for other chapters in this book

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Rizzetto, M. (2019). Hepatitis D Virus. In: Wong, R., Gish, R. (eds) Clinical Epidemiology of Chronic Liver Diseases. Springer, Cham. https://doi.org/10.1007/978-3-319-94355-8_11

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