In relation to an article titled "Diagnostic Efficacy of Serological Antibody Detection Tests for Hepatitis Delta Virus: A Systematic Review and Meta-Analysis" by Zhenzhen Pan et al. (2023)
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In the two methods of testing for HBV and HDV which are serological and molecular tests, co-infection with hepatitis virus (HBV) can affect the diagnosis of HDV infection which could lead to challenges in accurately detecting hepatitis delta virus (HDV) infection.
In serological tests, in acute HDV infection, HDV-antibody (Ab) persists for a very short time and is difficult to detect, thus, HDV-Ab seronegativity cannot rule out the occurrence of hepatitis D. In chronic HDV infection the HDV-Ab and HDV-antigen (Ag) form a circulating immune complex, thus, they need to be separated and then detected.
Meanwhile, from a molecular point of view, despite fluctuating patterns of HBV viral load in the presence of HDV in patients, several observations indicate that HDV has suppressive effects on HBV replication. In co-infected individuals, HBV RNA levels may be lower due to the suppressive effect of HDV on HBV replication as compared to HBV mono-infection which has higher quantity of HBV DNA. This can be likely caused as both viruses do not replicate independently from one another, but modulate each other’s replication level and also its pathogenicity.
References:
Chen S, Zhang X, Xu L, Tian Y, Fan Z, Cao Y, et al. Performance of Hepatitis Delta Virus (HDV) RNA Testing for the Diagnosis of Active HDV Infection: Systematic Review and Meta-analysis. J Clin Transl Hepatol. 2023;11(6):1368-1376. doi: 10.14218/JCTH.2022.00107.
Dastgerdi, E. S., Herbers, U., & Tacke, F. (2012). Molecular and clinical aspects of hepatitis D virus infections. World journal of virology, 1(3), 71–78. https://doi.org/10.5501/wjv.v1.i3.71
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