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Diagnostic Markers Significance
Anti-HDV IgG antibody
  • Positive in persons exposed to HDV
  • Persists, even after viral clearance
Anti-HDV IgM antibody
  • Positive in acute infection
  • Negative in past infection
  • Persists in many patients with chronic infection
HDV RNA

Qualitative

  • Marker of HDV replication
  • Positive in chronic infection
  • Negative in spontaneous or treatment-induced viral clearance

Quantitative

  • Useful in monitoring or predicting treatment response
HBsAg

Qualitative

  • Must be positive for HDV infectivity

Quantitative

  • Positively correlated with HDV RNA
  • Falling titer signals HBsAg loss, and hence HDV clearance
  • Useful in monitoring or predicting treatment response
HBeAg
  • Negative in an estimated 85% of patients
  • Associated with detectable anti-HBe
HBV DNA

Quantitative

  • Suppressed by HDV
  • Negative or low levels in most patients
  • May be increased in patients with detectable HBeAg
  • Can reactivate after spontaneous or treatment-induced clearance of HDV
ALT
  • Increased in most patients
  • Does not correlate well with degree of histological liver damage