Hepatitis D is a Delta virus characterized as a particle of 35 nm A37, consisting of a fragment of RNA and protein delta Ag (HDAg), both covered by the Ag surface of the Hepatitis B (HBsAg), which is the central cell. Requires prior HBV infection, who gives the Ag surface to form the roof, only to be captured achieves this requirement by the hepatocyte and develop their pathogenic action.

Transmission mechanism

1. Parenteral inoculation (drugs), percutaneous or mucous membrane.

2. Blood or blood products.

3. Sexual contact.

4. Rare mother-to-infant.

Epidemiology

1. Can cause an infection at the same time as the initial infection by Hepatitis B (infection) or can infect a person already chronically infected with HBV (superinfección.)

2. The incubation period for superinfection is 4 to 8 weeks ye coinfection is 45 to 160 days, averaging de120 days.

3. Regions of high prevalence in southern Italy, areas of eastern Europe, South America, Africa and Middle East.

4. Frequent in hemophiliacs.

Features

1. The combination HBV-HDV is rare, but drug users reach 50% and 80% in hemophiliacs.

2. This combination represents very serious cirrhosis or fulminant hepatitis in 80% and chronic hepatitis in 90%.

3. Delta antigen is still time course of surface antigen, appears at 1-2 weeks before the start and stays for 3 months or indefinite periods.

4. A person infected with Hepatitis B is a carrier of hepatitis B, it is impossible to avoid this infection and because the VHD is not neutralizing Ab or prevent infection, it prevents the use of immunoglobulin.

Diagnoses

1. Test for specific IgM antibodies and anti-HDV delta antigen (Ag Hepatitis D.)

2. If there are markers of HDV infection, coinfection with hepatitis B virus usually can be distinguished from the superinfection of an established carrier AgsHB by testing the antibody Hepatitis B core IgM class (anti-HBc IgM ).