Superinfection of HBV and HDV (HDV

Superinfection of HBV and HDV (HDV infection of a chronically infected HBV carrier) causes a generally severe acute hepatitis with short incubation time that leads to chronic type D hepatitis in up to 80% of cases. Superinfection is associated with fulminant acute hepatitis and severe chronic active hepatitis, often progressive to cirrhosis.14, 21During the acute phase of HDV infection, synthesis of both HBsAg and HBV DNA are inhibited until the HDV infection is cleared.14Fulminant viral hepatitis is rare, but still about 10 times more common in hepatitis D than in other types of viral hepatitis. It is characterized by hepatic encephalopathy showing changes in personality, disturbances in sleep, confusion and difficulty concentrating, abnormal behavior, somnolence and coma. The mortality rate of fulminant hepatitis D reaches 80%. Liver transplantation is indicated.14, 21Chronic viral hepatitis D is usually initiated by a clinically apparent acute infection. Symptoms are less severe than in acute hepatitis, and while serum ALT and AST levels are elevated, bilirubin and albumin levels and prothrombin time may be normal. In chronic hepatitis D, the HBV markers are usually suppressed.13, 14, 21Progression to cirrhosis usually takes 5 - 10 yrs, but it can appear 2 years after onset of infection. About 60 to 70% of patients with chronic hepatitis D develop cirrhosis. A high proportion of these patients die of hepatic failure

Superinfection of HBV and HDV (HDV infection of a chronically infected HBV carrier) causes a generally severe acute hepatitis. With short incubation time that leads to chronic type D hepatitis in up to 80% of cases. Superinfection is associated with. Fulminant acute hepatitis and severe chronic, active hepatitis often progressive, to cirrhosis.14 21

During the acute phase. Of, HDV infectionSynthesis of both HBsAg and HBV DNA are inhibited until the HDV infection is cleared.14

Fulminant viral hepatitis, is rare. But still about 10 times more common in hepatitis D than in other types of viral hepatitis. It is characterized by hepatic. Encephalopathy showing changes, in personality disturbances in sleep confusion and, difficulty concentrating abnormal behavior,,, Somnolence and coma.The mortality rate of fulminant hepatitis D reaches 80%. Liver transplantation, is indicated.14 21

Chronic viral hepatitis. D is usually initiated by a clinically apparent acute infection. Symptoms are less severe than in acute hepatitis and while,, Serum ALT and AST levels, are elevated bilirubin and albumin levels and prothrombin time may be normal. In chronic hepatitis. D.The HBV markers are usually suppressed.13 14 21,,

Progression to cirrhosis usually takes 5 - 10 yrs but it, can appear 2 years. After onset of infection. About 60 to 70% of patients with chronic hepatitis D develop cirrhosis. A high proportion of these. Patients die of hepatic failure.