Hepatitis Delta Virus Background

HDV was discovered following the detection of a novel antigen-antibody system in hepatitis B virus (HBV) carriers (Rizetto et al. 1977). Currently, HDV is classified as a subviral satellite of HBV due to an obligate relationship with HBV infections in nature. However, unlike other satellite viruses, the dependence of HDV on HBV is limited solely to the provision of an envelope of hepatitis B surface antigen for virus assembly. Nevertheless, this dependence requires that natural HDV infections occur as either a co-infection with HBV or as a super-infection of HBV carriers, with the resultant disease usually being more severe than that with HBV alone. Following HDV infection, the proportion of individuals that develops chronic disease is similar to that for HBV infections. Thus, approximately 5% of co-infected adults and almost all super-infected individuals will become carriers of both HBV and HDV. While there is currently still an estimated 15 million HDV carriers worldwide, public health initiatives established to control HBV have led to a very significant and welcome decline in the rate of new HDV infections.

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