HBV-HDV coinfection vs HDV superinfection
How to tell HBV-HDV coinfection and HDV superinfection apart when a board question makes them look alike.
Coinfection: simultaneous acute HBV and HDV that usually resolves; superinfection: HDV onto chronic HBV with high chronicity and rapid cirrhosis.
Side by side
Simultaneous acquisition of HBV and HDV in a previously uninfected person, causing acute hepatitis.
HDV infection in a person with preexisting chronic HBV, often causing abrupt worsening and higher severe/chronic risk.
HDV uses HBV surface antigen while both viruses are acquired together.
HDV enters an HBsAg-positive host and uses existing HBV surface antigen to package infectious virions.
Acute HBV markers with HDV markers at initial infection support coinfection.
Known chronic HBsAg positivity followed by new HDV markers and hepatitis flare supports superinfection.
The trap
HDV cannot make infectious virions without HBsAg, so resolved or vaccinated HBV does not support HDV infection.
The repair move
For HDV, first ask whether HBV was already chronic or acquired at the same time.
Try a free question
CoreA patient develops acute hepatitis and is found to have simultaneous new HBV and HDV infection. Which HDV pattern is this?
Show answer and explanation
Answer: A. Coinfection. HDV coinfection means HBV and HDV are acquired at the same time.
Why the other choices are tempting
- B. Superinfection means HDV infects a person who already has chronic HBV.
- C. Resolved HBV lacks the HBsAg needed for HDV replication.
- D. Vaccination prevents HBV and therefore prevents HDV dependence on HBV.
- E. HCV is a separate RNA virus and does not provide HBsAg for HDV.
Flashcards
Tap a card to flip it.
What does HDV need from HBV?
HDV requires HBsAg to package infectious particles.
What defines HBV-HDV coinfection?
HBV and HDV are acquired at the same time in a previously uninfected host.
Quick answers
What is the fastest way to tell HBV-HDV coinfection from HDV superinfection?
Coinfection: simultaneous acute HBV and HDV that usually resolves; superinfection: HDV onto chronic HBV with high chronicity and rapid cirrhosis.
What is the key clue for HBV-HDV coinfection?
Simultaneous acquisition of HBV and HDV in a previously uninfected person, causing acute hepatitis.
What is the key clue for HDV superinfection?
HDV infection in a person with preexisting chronic HBV, often causing abrupt worsening and higher severe/chronic risk.
What is the common trap with HBV-HDV coinfection vs HDV superinfection?
HDV cannot make infectious virions without HBsAg, so resolved or vaccinated HBV does not support HDV infection.