In most viral infections B- and T-cell immune responses contribute in a specific manner to antiviral defense. A successfully mounted immune response leads to elimination of the virus or persistence at low levels. For HDV infection the contribution of specific B- and T-cells for immunopathogenesis (e.g. liver damage) or elimination of HDV has not been clarified.

Approximately 80% of HBV carriers superinfected with HDV develop chronic infection. It is not known whether elimination of HDV is correlated to a specific T-cell response. As we will discuss below specific T-cell responses to HDV have been described in patients who recovered from HDV superinfection. However, the timing of the occurrence of this response in acute infection is not known. The specific CTL response identified so far is obviously not effective in eliminating the virus from the liver in the majority of cases.

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