User login
In Reply: We thank Dr. Homler for bringing hepatitis D as a potential cause of acute liver failure to our attention.
Hepatitis D virus, first described in the 1970s, requires the hepatitis B surface antigen (HBsAg) capsid to enter the hepatocyte and, thus, can only cause liver injury when the patient is also infected simultaneously with hepatitis B virus.1 Hepatitis D virus can cause either coinfection (presence of immunoglobulin M anti-HB core antibody with or without HBsAg) or superinfection (presence of HBsAg without immunoglobulin M anti-HB core antibody) with hepatitis B virus. In India, coinfection has been reported to be the cause of acute liver failure in about 4% of all patients, and superinfection in 4.5%.2
While simultaneous treatment for hepatitis D and B viruses with pegylated interferon and any of the agents used for treatment of hepatitis B has been successful in treating chronic hepatitis, it has not been proven useful in patients with acute liver failure, and liver transplant remains the only treatment option.3
- Rizzetto M. The adventure of delta. Liver Int 2016; 36(suppl 1):135–140.
- Irshad M, Acharya SK. Hepatitis D virus (HDV) infection in severe forms of liver diseases in North India. Eur J Gastroenterol Hepatol 1996; 8:995–998.
- Noureddin M, Gish R. Hepatitis delta: epidemiology, diagnosis and management 36 years after discovery. Curr Gastroenterol Rep 2014; 16:365.
In Reply: We thank Dr. Homler for bringing hepatitis D as a potential cause of acute liver failure to our attention.
Hepatitis D virus, first described in the 1970s, requires the hepatitis B surface antigen (HBsAg) capsid to enter the hepatocyte and, thus, can only cause liver injury when the patient is also infected simultaneously with hepatitis B virus.1 Hepatitis D virus can cause either coinfection (presence of immunoglobulin M anti-HB core antibody with or without HBsAg) or superinfection (presence of HBsAg without immunoglobulin M anti-HB core antibody) with hepatitis B virus. In India, coinfection has been reported to be the cause of acute liver failure in about 4% of all patients, and superinfection in 4.5%.2
While simultaneous treatment for hepatitis D and B viruses with pegylated interferon and any of the agents used for treatment of hepatitis B has been successful in treating chronic hepatitis, it has not been proven useful in patients with acute liver failure, and liver transplant remains the only treatment option.3
In Reply: We thank Dr. Homler for bringing hepatitis D as a potential cause of acute liver failure to our attention.
Hepatitis D virus, first described in the 1970s, requires the hepatitis B surface antigen (HBsAg) capsid to enter the hepatocyte and, thus, can only cause liver injury when the patient is also infected simultaneously with hepatitis B virus.1 Hepatitis D virus can cause either coinfection (presence of immunoglobulin M anti-HB core antibody with or without HBsAg) or superinfection (presence of HBsAg without immunoglobulin M anti-HB core antibody) with hepatitis B virus. In India, coinfection has been reported to be the cause of acute liver failure in about 4% of all patients, and superinfection in 4.5%.2
While simultaneous treatment for hepatitis D and B viruses with pegylated interferon and any of the agents used for treatment of hepatitis B has been successful in treating chronic hepatitis, it has not been proven useful in patients with acute liver failure, and liver transplant remains the only treatment option.3
- Rizzetto M. The adventure of delta. Liver Int 2016; 36(suppl 1):135–140.
- Irshad M, Acharya SK. Hepatitis D virus (HDV) infection in severe forms of liver diseases in North India. Eur J Gastroenterol Hepatol 1996; 8:995–998.
- Noureddin M, Gish R. Hepatitis delta: epidemiology, diagnosis and management 36 years after discovery. Curr Gastroenterol Rep 2014; 16:365.
- Rizzetto M. The adventure of delta. Liver Int 2016; 36(suppl 1):135–140.
- Irshad M, Acharya SK. Hepatitis D virus (HDV) infection in severe forms of liver diseases in North India. Eur J Gastroenterol Hepatol 1996; 8:995–998.
- Noureddin M, Gish R. Hepatitis delta: epidemiology, diagnosis and management 36 years after discovery. Curr Gastroenterol Rep 2014; 16:365.