Based on the study "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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Based on the journal provided, the current gold standard for diagnosing HDV infection is the HDV RNA. However, there are several limitations associated with this method. Firstly, PCR testing can only detect active HDV RNA replication, which might be suppressed during therapy. Secondly, HDV RNA has a high GC content of up to 60%, with about 74% of its bases forming complementary pairs within the molecule. This high proportion and complementarity of GC in HDV RNA pose significant technical challenges for its amplification. Lastly, due to the wide genetic variability of HDV RNA, there is no fully standardized PCR detection technique available yet, leading to non-comparable results from different laboratories.
Reference: Pan, Z., Chen, S., Li, X., 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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