Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China.
Gastroenterology and Hepatology, NYU Langone Health, NYU Grossman School of Medicine, New York, USA.
Dig Dis Sci. 2023 Aug;68(8):3237-3248. doi: 10.1007/s10620-023-07960-y. Epub 2023 Jun 20.
Hepatitis D virus (HDV) depends on hepatitis B virus (HBV) to enter and exit hepatocytes and to replicate. Despite this dependency, HDV can cause severe liver disease. HDV accelerates liver fibrosis, increases the risk of hepatocellular carcinoma, and hastens hepatic decompensation compared to chronic HBV monoinfection. The Chronic Liver Disease Foundation (CLDF) formed an expert panel to publish updated guidelines on the testing, diagnosis, and management of hepatitis delta virus. The panel group performed network data review on the transmission, epidemiology, natural history, and disease sequelae of acute and chronic HDV infection. Based on current available evidence, we provide recommendations for screening, testing, diagnosis, and treatment of hepatitis D infection and review upcoming novel agents that may expand treatment options. The CLDF recommends universal HDV screening for all patients who are Hepatitis B surface antigen-positive. Initial screening should be with an assay to detect antibodies generated against HDV (anti-HDV). Patients who are positive for anti-HDV IgG antibodies should then undergo quantitative HDV RNA testing. We also provide an algorithm that describes CLDF recommendations on the screening, diagnosis, testing, and initial management of Hepatitis D infection.
丁型肝炎病毒（HDV）依赖乙型肝炎病毒（HBV）进入和离开肝细胞并进行复制。尽管存在这种依赖性，但 HDV 可导致严重的肝脏疾病。与慢性 HBV 单感染相比，HDV 可加速肝纤维化、增加肝细胞癌的风险并加速肝失代偿。慢性肝病基金会（CLDF）成立了一个专家小组，发布了关于丁型肝炎病毒检测、诊断和管理的更新指南。该专家组对急性和慢性 HDV 感染的传播、流行病学、自然史和疾病后果进行了网络数据审查。基于目前可用的证据，我们为丁型肝炎感染的筛查、检测、诊断和治疗提供了建议，并回顾了可能扩大治疗选择的新型药物。CLDF 建议对所有乙型肝炎表面抗原阳性的患者进行普遍的 HDV 筛查。初始筛查应使用检测针对 HDV 产生的抗体（抗-HDV）的检测方法。抗-HDV IgG 抗体阳性的患者应进行定量 HDV RNA 检测。我们还提供了一个算法，描述了 CLDF 关于丁型肝炎感染筛查、诊断、检测和初始管理的建议。
