In relation to the systematic review and meta-analysis of Zhenzhen Pan et al. (2023) about the Diagnostic Efficacy of Serological Antibody Detection Tests for Hepatitis Delta Virus.
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Based on the journal provided, the two main categories of diagnostic tests for HDV are molecular tests for viral RNA and serological tests for anti-HDV antibodies. Molecular tests focus on detecting viral RNA, which is considered the reference standard for HDV diagnosis due to its high specificity and sensitivity. Serological tests primarily detect IgG and IgM antibodies against HDV. Anti-HDV IgG positivity persists for a long time after virus clearance, while anti-HDV IgM antibody is detectable within 2-3 weeks of symptom onset but disappears 2 months after acute infection. Furthermore, the detection method for HDV antibodies can be influenced by the genotype of HDV, with different genotypes potentially affecting the accuracy of antibody detection.
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In the inherent study, Zhenzhen et al. discussed two approaches for detecting Hepatitis D antibodies. The first involves molecular tests targeting viral RNA, which are considered the benchmark for HDV infection diagnosis due to their exceptional specificity and sensitivity. For instance, HDV RNA detection methods exhibit notably high diagnostic efficacy. However, despite their status as the "gold standard," these methods present several limitations that complicate HDV diagnosis. Conversely, serological methods constitute the alternative approach, focusing on detecting anti-HDV antibodies. Unlike molecular assays, these serological techniques offer rapid, cost-effective, and user-friendly options; nevertheless, they are comparatively less specific and sensitive.
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The two main categories of diagnostic tests for HDV infection are molecular tests for viral RNA, and serological tests for anti-HDV antibodies.
Molecular tests detect viral HDV RNA. According to the study of Pan et al. (2023), the detection of viral HDV RNA has high specificity and high sensitivity, hence it is widely used as a reference standard for the diagnosis of HDV. In addition to that, they have found that HDV viral RNA detection has high diagnostic efficacy. This method, however, has limitations, such that it requires trained technicians, takes a long time to generate results, and the equipment needed is expensive.
On the other hand, serological tests detect two antibodies, which are the IgG and IgM antibodies against HDV. Its advantages over molecular testing include being quick, cost-effective, and having simple operation. In the study by Pan et al. (2023) which seeks to determine the diagnostic efficacy of serological antibody detection tests for HDV through a systematic review and meta-analysis, the results of their meta-analysis found that IgM detection is accurate for diagnosing HDV. As for IgG detection, the study found no significant difference between IgM and IgG in terms of sensitivity and specificity due to being able to retrieved four studies related to HDV IgG infection. In terms of anti-HDV total antibodies, it was found that specificities were lower compared with IgM and IgG. Overall, the results of their study showed that the detection of anti-HDV IgM and IgG has good performance, and that in terms of accuracy and simplicity, is a better choice for HDV diagnosis.
In the same study however (Pan et al. 2023), limitations for serological testing exist. One of the limitations mentioned in the study was the genotype of HDV, as it will affect the accuracy of the results should the HDV antibody detection method is established for a certain HDV genotype. In addition to that, the duration of the antibodies was also a limitation, as anti-HDV IgM is detectable within 2-3 weeks of symptom onset and disappears 2 months after acute infection.
Reference:
Pan, Z., Chen, S., Xu, L., Gao, Y., Cao, Y., Fan, Z., Tian, Y., Zhang, X., Duan, Z., & Ren, F. (2023). Diagnostic Efficacy of Serological Antibody Detection Tests for Hepatitis Delta Virus: A Systematic Review and Meta-Analysis. Viruses, 15(12), 2345. https://doi.org/10.3390/v15122345
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