PDF(Pubmed)
Abstract：
Hepatitis D virus (HDV) depends on hepatitis B virus (HBV) to enter and exit hepatocytes and to replicate. Despite this dependency, HDV can cause severe liver disease. HDV accelerates liver fibrosis, increases the risk of hepatocellular carcinoma, and hastens hepatic decompensation compared to chronic HBV monoinfection. The Chronic Liver Disease Foundation (CLDF) formed an expert panel to publish updated guidelines on the testing, diagnosis, and management of hepatitis delta virus. The panel group performed network data review on the transmission, epidemiology, natural history, and disease sequelae of acute and chronic HDV infection. Based on current available evidence, we provide recommendations for screening, testing, diagnosis, and treatment of hepatitis D infection and review upcoming novel agents that may expand treatment options. The CLDF recommends universal HDV screening for all patients who are Hepatitis B surface antigen-positive. Initial screening should be with an assay to detect antibodies generated against HDV (anti-HDV). Patients who are positive for anti-HDV IgG antibodies should then undergo quantitative HDV RNA testing. We also provide an algorithm that describes CLDF recommendations on the screening, diagnosis, testing, and initial management of Hepatitis D infection.
摘要：
丁型肝炎病毒（HDV）依赖于乙型肝炎病毒（HBV）进入和退出肝细胞和复制。尽管有这种依赖，HDV可导致严重的肝脏疾病。HDV加速肝纤维化，增加肝细胞癌的风险，与慢性HBV单一感染相比，加速肝失代偿。慢性肝病基金会（CLDF）成立了一个专家小组，以发布有关测试的最新指南，诊断,和丁型肝炎病毒的管理。专家组对传输进行了网络数据审查，流行病学,自然史,以及急性和慢性HDV感染的疾病后遗症。根据现有证据,我们提供筛查建议，测试,诊断,和丁型肝炎感染的治疗，并回顾即将到来的新药物，可能扩大治疗方案。CLDF建议对所有乙型肝炎表面抗原阳性的患者进行通用HDV筛查。初始筛选应采用检测针对HDV（抗HDV）产生的抗体的测定法。抗HDVIgG抗体阳性的患者应进行定量HDVRNA检测。我们还提供了一个算法，描述了CLDF关于筛查的建议，诊断,测试,和丁型肝炎感染的初步管理。
