Clinical Manifestations of Hepatitis D Virus
Author: mzPOTTER
Infection with hepatitis D always occurs in the presence of infection with hepatitis B virus. Usually the hepatitis D virus inhibits HBV replication, so that liver disease is caused by D virus in patients with chronic infection. It can be distinguished 3 clinical forms of infection:
Co-infection: This occurs with exposure of an individual susceptible to the virus simultaneously B and D. Its clinical presentation is indistinguishable from a classical hepatitis B, although often more serious and can have a biphasic course. Frequently recovered, since it depends on B virus for replication. The rate of chronicity of hepatitis B (5% in adults) is not affected by the presence of infection by viruses D.
Superinfection: Occurs when an individual chronic carrier of hepatitis B is exposed to hepatitis D. Is often manifested as a severe hepatitis and almost all patients become chronic.
Latent infection, have been reported after liver transplantation D virus can remain dormant in the absence of demonstrable virus B infection and only become apparent if the B virus evades neutralization by hyperimmune immunoglobulin (HBIg).
Chronic infection with hepatitis D direct cytopathic liver damage occurs during the acute phase and immune-mediated damage in the chronic stage. This damage is associated with the development of liver cirrhosis and hepatocellular carcinoma. While its evolution is generally faster and the risk of hepatocellular carcinoma is higher than in chronic hepatitis B have been reported in chronic carriers of hepatitis D with little liver damage. Is fairly well described that a group of patients with hepatitis D can evolve rapidly to liver cirrhosis in a few years, but subsequently decrease viral replication, keeping compensated for prolonged periods.