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Hepatitis D General Clinical Tests

Test Name
Method		 Hepatitis Delta Antigen and Antibody (HDAg; anti-HD)
Solid-phase EIA
Specimen
Requirements		 Serum.
Stable for 7 d at RT and indefinately at 4°
Ref. Range
Conventional
International Recommended Units

Negative
Chemical Interfaces
In Vivo Effects		 None found
Diagnostic Information Hepatitis Delta is a generate RNA virus or nirusoid that requires the surface coat of Hepatitis B (HBsAg) in order to become an infectious virus. After transcription of the RNA into mRNA, the virus produces a protein, HDAg, which might interfere with translation of other mRNA's and produce cell damage. When Hepatitis D infection occurs simultaneously with Hepatitis B, the course of infections tends to be self-limited. However, in the case of acute Hepatitis D superinfection of an established Hepatitis B infection, there is much more Hepatitis D replication, and a more severe clinical hepatitis occurs. In this situation, the Hepatitis D infection usually becomes chronic. Anti-HD does not necessarily indicate active infection, but the ;presence of HDAg does.
Remarks The role of testing for either HDAg or anti-HD is currently controversial. Genereally one tests for Hepatitis D only patients with markers for Hepatitis B. It has been suggested, for prognostic reasons, that all patients with chronic Hepatitis B be tested for anti-HD, especially if there is exacerbation of a stable hepatitis.

References:
Clinical Guide to Laboratory Tests, third edition.

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