Hepatitis D virus and liver transplantation: Indications and outcomes

Abstract

Hepatitis D virus (HDV) is a dependent virus that relies on hepatitis B virus for its replication and transmission. Chronic hepatitis D is a severe form of viral hepatitis that can result in end stage liver disease. Currently, pegylated interferon alpha is the only approved therapy for chronic HDV infection and is associated with significant side effects. Liver transplantation (LT) is the only treatment option for patients with end-stage liver disease, hepatocellular carcinoma, or fulminant hepatitis due to coinfection with HDV. As LT for HDV and hepatitis B virus coinfection is uncommon in the United States, most data on the long-term impact of LT on HDV are from international centers. In this review, we discuss the indications and results of LT with treatment options in HDV patients.

Severe Acute Hepatitis of Unknown Etiology in Indonesia: What Has Been Learned?

“…64 Acute HDV infection has an incubation period of around one month. 65 After the incubation period, clinical symptoms, such as fatigue, nausea, loss of appetite, and jaundice, may arise in patients with hepatitis D. 65 HDV infection causes a very high mortality rate of around 2-20%.among viral hepatitis sufferers. 66 Chronic infection of HDV is the most dangerous of all chronic viral hepatitis, in which 70-80% of patients develop cirrhosis within 5-10 years, and once cirrhosis been developed, their mortality rate is between 51-60%.…”

“…Subsequently, patients are tested serologically for anti-HDV IgG antibodies. 61, 65 As positive results of this test could not inform whether HDV infection is still active, the infection would be confirmed by using a molecular approach, i.e., qPCR for HDV RNA. 61, 65 The pathogenicity of acute hepatitis D has not been thoroughly elucidated.…”

Hepatocellular Carcinoma and the Role of Liver Transplantation: A Review

“… 11 Interestingly, hepatitis D virus when coinfected with HBV results in severe hepatitis and is reported to have oncogenic properties leading to HCC. 12 …”

An Update on Usage of High-Risk Donors in Liver Transplantation

“…Around 0.24 billion people in the world are positive for hepatitis B surface antigen (HBsAg) [ 27 ]. In the current era, using hepatitis B immune globulin (HBIG) and antivirals post transplantation has decreased the incidences for recurrence of HBV and improved overall survival [ 28 ].…”