Acute hepatitis D

**Definition:** Acute liver injury and inflammation caused by recent and short-term (less than 6 months) infection with hepatitis D virus (HDV). Transmission only occurs in someone with chronic HBV infection (super-infection) or at the same time as acute hepatitis B (co-infection), and is by blood and body fluid contamination (parenteral spread), and sexual spread. Diagnosis is confirmed by serum IgM-anti-HDV. Clinical features, if they occur, are characterised by anorexia, nausea and fever, with jaundice in severe cases. Acute liver failure occurs in some cases, and a high proportion of cases develops chronic HDV infection.

**Long definition:** Super-infection is defined as acute hepatitis D infection in carrier person with chronic hepatitis B virus infection. Early responses both serum IgM and IgG anti HDV are observed. On the other hand, serum IgM anti HBc is usually negative or positive only at low-titer.