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Hepatitis D question
May 23, 2000

Dr, Thank You for your efforts on this site. I understand Hep D needs the HBsAg. After an acute Hep B and generation of AntiHBs with clearance of HBsAg, and assuming, a co-infection with HepB during the acute phase. Can HepD stick around even if the body developed antibodies for HB? I am asking the question because my liver tests are on the "higher" side for ALT and Alk. Phos. however, I have AntiHBs (which means no chronic infection with HB and naturally immune). Should I test for HepD? Thanks

Response from Dr. Pavia

A very good question. Hep D is a very unusual virus. It needs to infect a cell which is also actively infected with Hep B in order to reproduce. Clinically, what we see is either someone with stable but chronic Hep B (Hep BsAg positive) who suddenly becomes much worse, or someone who is simultaneously co-infected with both, and usually has a severe course.

Bottom line is that if you are HbSAb positive (antiHbS) and HbSAg negative, you have cleared your infection, and to our knowledge, cannot be affected by Hep D. Hope this helps

Andrew T. Pavia, M.D.

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