Most RNA viruses encode their own RNA polymerases for genome replication, and increasing numbers of them appear to be capable of undergoing RNA recombination. Here, we provide the first report of intergenotypic recombination in hepatitis delta virus (HDV), the only animal RNA virus that requires host RNA polymerase(s) for viral replication. In vivo, we analyzed RNA species derived from the serum of a patient with mixed genotype I and genotype IIb HDV infection by using multiple restriction fragment length polymorphism (RFLP) assays and sequence analysis of cloned reverse transcription (RT)-PCR products. Six HDV recombinants were isolated from 101 tested clones, and HDV recombination in this patient was further confirmed by RT-PCR with genotype-specific primer pairs. Analysis of the recombination junctions suggested that the HDV genome rearrangement occurred through faithful homologous recombination. We then used an RNA cotransfection cell culture system to investigate HDV RNA recombination in vitro. We found that HDV recombinants could indeed be detected in the transfected cells; some of these possessed recombination junctions identical to those identified in vivo. Furthermore, using a PCR-independent RNase protection assay, we were able to readily identify the recombined HDV RNA species in cultured cells. Taken together, our results demonstrate that HDV RNA recombination occurs in both natural HDV infections and cultured cells, thereby presenting a novel mechanism for HDV evolution.Hepatitis delta virus (HDV) is a subviral agent of the hepatitis B virus that requires hepatitis B surface antigen for its assembly and transmission (48,49). HDV is unique among animal viruses in that it resembles some plant pathogens, such as viroids, in having a circular RNA with an unbranched rodlike structure (25, 59), and a replication strategy that utilizes host RNA polymerases (Pols) (37, 41). Upon entering a cell, genomic HDV RNA is transcribed into complementary subgenomic mRNA for the delta antigen (HDAg) (15) and multimeric antigenomic RNAs (31, 57). These then undergo selfcleavage and ligation to generate unit-length circular RNA (27,46,53,63). Similarly, the circular antigenomic RNA serves as a template for production of additional genomic RNA.In both virions and cells, the HDV RNA forms a ribonucleoprotein complex with HDAg (9, 35). There are two forms of HDAg, small and large, which play distinct biological roles. The small HDAg (195 amino acids) is required for HDV RNA replication (8,29). The large HDAg is produced through specific RNA editing by the small form of the cellular enzyme ADAR1 (20,44,62), which converts the UAG stop codon for the small HDAg into a UGG tryptophan codon (36). This process leads to translation of an additional 19 amino acids and creates the large HDAg (214 amino acids), which in turns inhibits genome replication and is required for packaging (6,8).Viral hepatitis due to HDV infection has been found worldwide, and the complete nucleotide (nt) sequences of HDV genomes have been reported from m...