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Deltavirus

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Summary

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Key Points

  • Deltaviruses
    • May be referred to as “delta agents”
    • Characteristics
      • RNA viruses
        • replicate in the cytoplasm of cells
        • Single-stranded
        • - sense
        • Circular
      • Enveloped
      • Unknown capsid symmetry
    • Presentation
      • Hepatitis D Virus (HDV)
        • Transmission
          • Parenteral (blood), sexual, perinatal
        • Pathogenesis
          • Replication defective; requires presence of HBV to replicate
            • Hepatitis D antigen requires HBV HBsAg coat for entry into hepatocytes
            • Superinfection (HDV on chronic HBV) → short course
            • Coinfection (HDV with acute HBV) → longer course
        • Presentation
          • Short incubation period
          • Hepatitis
            • Fever, jaundice, elevated ALT and AST
            • Chronic hepatitis can lead to cirrhosis and HCC
        • Diagnosis
          • HDAg - seen in acute infection
          • anti-HDV - seen in chronic infection
          • Diagnosis of HBV
          • Liver Biopsy
            • Similar to HBV
            • All viral hepatitis produce a similar histopathological pattern
              • Panlobular infiltrates, ballooning hepatocytes, hepatocyte necrosis, and hepatocyte apoptosis
              • Apoptotic bodies form round pink (eosinophilic) bodies known as Councilman bodies
        • Treatment
          • Pegylated interferon (PegIFN)