Diagnosis and Treatment
Diagnosis
Hepatitis
D should be considered as a possibility in anyone who has evidence of HBV
infection, especially if they have sever hepatitis B. The diagnosis of
Hepatitis D is made on the basis of serologic tests for antibodies to the delta
antigen. This test can be done by RIA or EIA. The Anti-D antibodies show up in
the acute phase of both the superinfection and coinfection clinical patterns. Reverse transcription PCR is
another possibility for detecting HDV virema – PCR is the most sensitive method
to diagnose HDV.
Treatment
Unfortunately,
there is no specific treatment for type D hepatitis. One treatment that was
tried was immunosuppressive therapy but that was found to be ineffective. Low
and moderate does of interferon-alpha has shown
to have an inhibitory effect on HDV replication, but like interferon treatment
for general HBV, the beneficial effects of the treatment were transitory. One
recent study, by Lau et. al, showed that a very
high dose of interferon given over 12 years can effectively cure someone with
HDV/HBV infection. More study is needed in this area, however. As a last
resort, orthotopic liver transplant has been relatively successful for treating
fulminant acute and end-stage chronic hepatitis D. In fact there is evidence
that liver transplant is more helpful in patients with HDV-HBV coinfection than
in patients with just HBV.
"Ten Surgeons in Pink Transplant a Liver" Xavier Cugat