Hepatitis D virus

Abstract

Hepatitis D is caused by the hepatitis D virus (HDV), a ubiquitous RNA agent which depends upon the envelope proteins of the hepatitis B virus (HBV) for assembly of progeny virus. The infection is transmitted parenterally as well as sexually. Intravenous drug users are at the highest risk of infection. HBV infected patients who become superinfected with HDV are the major reservoir of the virus due to the high rate of chronicity. With the advent of universal HBV vaccination, the incidence of hepatitis D has declined in developed and developing countries. Residual disease persists in the aging domestic population of Southern Europe and in injection drug users and immigrants throughout Europe and the United States, with high concentrations in Mongolia and northwestern Amazonia as well as pockets of high-risk people in other countries. The prevalence of hepatitis D remains high and has a major medical impact in many areas of the developing world where HBV remains endemic and not controlled.