Testing and Diagnosis
Who should be tested?
While the American Association for the Study of Liver Diseases (AASLD) reccomends that only high-risk groups be tested for hepatitis delta, the Hepatitis B Foundation recommends that all people living with hepatitis B get tested.
Types of infections:
There are two types of hepatitis delta infections, "superinfection" and "coinfection". Superinfections can occur when someone who already has chronic hepatitis B becomes infected with hepatitis delta - these types of infections are more common, and have a 70-90% chance of resulting in a chronic infection of both hepatitis B and delta. Coinfections can occur when someone becomes infected with hepatitis B and delta at the same time, and have a <5% chance of resulting in chronic infections. If available, testing for the HDV Antibody IgM can help determine if someone is experiencing a new hepatitis delta infection.
A hepatitis delta diagnosis will require two tests, the hepatitis delta antibody (Anti-HDV total) test and the hepatitis delta RNA (HDV RNA) test. The first step is performing the HDV antibody total (anti-HDV) test. People who have recovered from or are currently infected with hepatitis delta will have antibodies. If the HDV antibody total test is positive, it should be followed by the HDV RNA (Qualitative or Quantitative) test to confirm an active infection. If this test is negative, a current infection is unlikely.
In the past, availability and accuracy of testing for hepatitis delta has been limited. However, recent advancements have given more hope for this type of testing, which is now available from several labs within the U.S. and internationally:
Cambridge Biomedical (US, Limited States)
Disclaimer: This may not be a comprehensive list of all available labs offering hepatitis delta testing.
Please note, if you are a patient in the U.S. and wish to be tested for hepatitis D, these tests must be ordered through a clinician or through Quest's 'Request a Test' option.