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Epidemiology and Prevention of Viral Hepatitis A to E: Hepatitis D (Delta) Virus Division of Viral Hepatitis Hepatitis D (Delta) Virus d antigen HBsAg RNA Geographic Distribution of HDV Infection Taiwan Pacific Islands HDV Prevalence High Intermediate Low Very Low No Data Hepatitis D - Clinical Features • Coinfection with HBV severe acute disease – low risk of chronic infection – • Superinfection on top of chronic HBV – usually develop chronic HDV infection – high risk of severe chronic liver disease HBV – HDV Coinfection Typical Serological Course Symptoms ALT Elevated Anti-HBs IgM anti-HDV HDV RNA HBsAg Time after Exposure Total anti-HDV HBV – HDV Super-infection Typical Serological Course Jaundice Symptoms Total anti-HDV ALT HDV RNA HBsAg IgM anti-HDV Time after Exposure Hepatitis D Virus Modes of Transmission • Percutanous exposures injecting drug use • Permucosal exposures sex contact Hepatitis D - Prevention • HBV-HDV Coinfection – Pre or postexposure prophylaxis to prevent HBV infection (HBIG and/or Hepatitis B vaccine) • HBV-HDV Superinfection – Education to reduce risk behaviors among persons with chronic HBV infection