Gastroenterology ·
AASLD expert opinion recommends universal HDV testing in HBsAg-positive people
An AASLD-commissioned Expert Practice Opinion, based on a targeted literature review and expert consensus, addresses hepatitis delta virus screening, diagnosis and management. It recommends one-time HDV antibody testing for all people who are HBsAg-positive and outlines monitoring and treatment options for chronic infection.
- Test HBsAg-positive individuals for HDV antibodies at least once.
- Confirm active infection with HDV RNA testing.
- Consider six-monthly laboratory monitoring and HCC surveillance.
- Consider therapy for chronic HDV with compensated liver disease.
Hepatitis delta virus (HDV) can occur as a co-infection or superinfection in people with hepatitis B virus (HBV) infection and is associated with liver complications, including hepatic decompensation and hepatocellular carcinoma. This AASLD-commissioned Expert Practice Opinion was developed by subject-matter experts following a targeted literature review; its statements were agreed by group consensus. It is guidance, not a clinical trial, and no patient sample was reported.
The document recommends testing all HBsAg-positive individuals at least once for HDV antibodies. Those who test positive should have HDV RNA testing to confirm active infection. For chronic HDV, it recommends evaluation for fibrosis, preferably using elastography, and suggests laboratory monitoring and HCC surveillance imaging every six months. Adults with chronic HDV viremia and compensated liver disease should be considered for therapy with bulevirtide; bulevirtide plus peg-IFN alfa-2a is presented as an alternative for eligible adults seeking a finite-duration regimen.
These recommendations provide a screening and care framework, but the source does not report comparative treatment outcomes or quantify effects on clinical events. Treatment selection is subject to patient eligibility and contraindications, and the document describes itself as an Expert Practice Opinion rather than a formal guideline.
In practice
The opinion recommends one-time HDV antibody testing for all HBsAg-positive individuals, followed by HDV RNA testing when antibodies are present. For chronic HDV, it advises fibrosis assessment, preferably with elastography, and suggests laboratory monitoring and HCC surveillance every six months. Adults with chronic viremia and compensated liver disease should be considered for bulevirtide, with bulevirtide plus peg-IFN alfa-2a an option for eligible patients seeking a finite-duration regimen. These are consensus-based recommendations following a targeted literature review; the supplied text provides no comparative outcome estimates.
AI-generated clinical interpretation · Not editor-reviewed
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Hepatology: AASLD EXPO: Diagnosis and management of hepatitis delta virus (HDV) infection ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.