ABSTRACT

Hepatitis delta virus ( HDV) is a defective RNA virus which needs HBsAg for replication. The outcome of disease largely depends on whether two viruses infect simultaneously (coinfection), or whether the newly hepatitis delta virus-infected person is a chronically infected hepatitis B carrier (superinfection). Epidemiologic features of hepatitis B (HBV) and delta viruses in the world have the same characteristics generally, but vary in some regions. Turkey is in a region of moderate endemicity for hepatitis B; delta superinfection is frequently observed while coinfection is rarer. Since the cases of delta coinfection are rarely seen in our country, we wanted to present a 48-year-old female admitted to our clinic with the complaints of weakness, anorexia and nausea. Laboratory findings were as follows: ALT: 2472 U/L, AST: 2320 U/L, total bilirubin: 5.96 mg/dL, direct bilirubin: 4.2 mg/dL, HBsAg: positive, anti-HBc IgM: positive, anti-delta antibody: positive. The patient was diagnosed with hepatitis delta coinfection based on the clinical/laboratory findings. Elevated liver transaminase levels as well as anti-HBc IgM and anti-delta antibody positivity are the hallmark of the diagnosis of acute delta coinfection in suspected patients. However, delta antibodies should be investigated to make the diagnosis of hepatitis delta infection in patients with hepatitis B virus.