Short article: Hepatitis delta in patients with resolved hepatitis B virus infection

Background The hepatitis delta virus (HDV) causes the most aggressive form of chronic viral hepatitis. As HDV replication requires hepatitis B virus (HBV), HDV screening is limited to HBsAg+ carriers. To date, individuals with HDV-antibodies and markers of resolved hepatitis B are considered cured. However, a subset shows elevated liver enzymes and hepatic fibrosis. Could they represent HBsAg-seronegative occult HDV infections? Methods We tested for HDV-antibodies 406 individuals with markers of past HBV exposure. Results Overall, 20 (4.9%) were reactive for HDV-antibodies. All were negative for serum HDV-RNA, including four with elevated liver enzymes. Conclusion These results support the current policy of screening for hepatitis delta only in HBsAg+ individuals.