TY  - CHAP
M1  - Book, Section
TI  - Chronic Hepatitis D (Delta Hepatitis)
A1  - Dienstag, Jules L.
A2  - Jameson, J. Larry
A2  - Fauci, Anthony S.
A2  - Kasper, Dennis L.
A2  - Hauser, Stephen L.
A2  - Longo, Dan L.
A2  - Loscalzo, Joseph
Y1  - 2018
N1  - 
T2  - Harrison's Principles of Internal Medicine, 20e
AB  - Chronic  hepatitis  D  virus  (HDV)  may  follow  acute  co-infection  with  HBV  but  at  a  rate  no  higher  than  the  rate  of  chronicity  of  acute  hepatitis  B.  That  is,  although  HDV  co-infection  can  increase  the  severity  of  acute  hepatitis  B,  HDV  does  not  increase  the  likelihood  of  progression  to  chronic  hepatitis  B.  When,  however,  HDV  superinfection  occurs  in  a  person  who  is  already  chronically  infected  with  HBV,  long-term  HDV  infection  is  the  rule,  and  a  worsening  of  the  liver  disease  is  the  expected  consequence.  Except  for  severity,  chronic  hepatitis  B  plus  D  has  similar  clinical  and  laboratory  features  to  those  seen  in  chronic  hepatitis  B  alone.  Relatively  severe  and  progressive  chronic  hepatitis,  with  or  without  cirrhosis,  is  the  rule,  and  mild  chronic  hepatitis  is  the  exception.  Occasionally,  however,  mild  hepatitis  or  even,  rarely,  inactive  carriage  occurs  in  patients  with  chronic  hepatitis  B  plus  D,  and  the  disease  may  become  indolent  after  several  years  of  infection.  A  distinguishing  serologic  feature  of  chronic  hepatitis  D  is  the  presence  in  the  circulation  of  antibodies  to  liver-kidney  microsomes  (anti-LKM);  however,  the  anti-LKM  seen  in  hepatitis  D,  anti-LKM3,  are  directed  against  uridine  diphosphate  glucuronosyltransferase  and  are  distinct  from  anti-LKM1  seen  in  patients  with  autoimmune  hepatitis  and  in  a  subset  of  patients  with  chronic  hepatitis  C  (see  below).  The  clinical  and  laboratory  features  of  chronic  HDV  infection  are  summarized  in  Chap.  332.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/19
UR  - accessmedicine.mhmedical.com/content.aspx?aid=1178426863
ER  -