Hepatitis D laboratory tests

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Varun Kumar, M.B.B.S. [2]

Lab Tests

• Detection of HDV RNA using reverse transcriptase polymerase chain reaction assay has a high sensitivity in detection of HDV viremia.
• HDV antigen may be detected.
• Levels of anti-delta agent antibodies such as IgM and IgG are generally be elevated. Detection of IgA antibodies to HDV is exclusively associated with chronic HDV infection.
• Patients may also be positive for HBsAg and anti-HB core IgM. However HBsAg levels may be suppressed to undetectable levels with active HDV replication.
• Liver function tests may generally show elevated serum alanine aminotransferase and aspartate aminotransferase levels.
• Elevated international normalized ratio (INR) with prolongation of prothrombin time suggests fulminant hepatic failure.