HDV prevalence must not be disregarded, as the virus is associated with a higher severity of hepatic disease. All HBV carriers should be tested for HDV as well, at least once during the disease history, and in case of worsening of a chronic HBV hepatitis. Diagnosis should rely on anti-HDV antibody testing, and confirmed by HDV RNA detection and quantification by RT-qPCR. The only treatment available is pegylated alpha interferon. Optimal duration of treatment has not yet been proven, and relapses are common. Disease follow-up should be carried on even when SVR is obtained, in order to track late viral relapses, and fibrosis complications (such as HCC screening).
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