Chapter 58 : Hepatitis D

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Hepatitis D, Page 1 of 2

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Hepatitis D virus (HDV) is unique in animal virology and pathology. It has a circular RNA genome of the smallest size among human viruses, requires the hepatitis B surface antigen (HBsAg) capsid provided by the hepatitis B virus (HBV) to assemble into infectious virions, parasitizes the transcriptional machinery of the host by hijacking cellular RNA polymerases to replicate its RNA genome, and is replicated by a rolling circle mechanism unknown in mammalian cells.

Citation: Rizzetto M, Smedile A, Ciancio A. 2017. Hepatitis D, p 1409-1423. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch58
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Image of FIGURE 1

A: Schematic representation of HDV B: The HDV particle in electron microscopy.

Citation: Rizzetto M, Smedile A, Ciancio A. 2017. Hepatitis D, p 1409-1423. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch58
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Image of FIGURE 2

Circular HDV-RNA genome and antigenome (unbranched rodlike structures). Rybozime (solid green box). Open reading frames for the small and large HD antigens (solid brown box). Short linear messenger RNA(mRNA) containing the AAUAAA polyadenylation signal and the editing site. (Reprinted with permission from reference [ ].)

Citation: Rizzetto M, Smedile A, Ciancio A. 2017. Hepatitis D, p 1409-1423. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch58
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Image of FIGURE 3

Rolling-model for the replication of the HDV-RNA genome. Redirection of host polymerases produce multimeric transcripts of HDV-RNA which undergo self cleavage and ligation to unit-length circular RNAs through the catalysis of the HDV ribozymes (filled rectangles). (Reprinted with permission from reference [ ].)

Citation: Rizzetto M, Smedile A, Ciancio A. 2017. Hepatitis D, p 1409-1423. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch58
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Image of FIGURE 4

Global epidemiology of HDV infection according to viral genotype. (Reprinted with permission from reference [ ].)

Citation: Rizzetto M, Smedile A, Ciancio A. 2017. Hepatitis D, p 1409-1423. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch58
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Image of FIGURE 5

Serologic profile of HBV/HDV coinfection.

Citation: Rizzetto M, Smedile A, Ciancio A. 2017. Hepatitis D, p 1409-1423. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch58
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Image of FIGURE 6

Serologic course of HDV superinfection evolving to chronicity.

Citation: Rizzetto M, Smedile A, Ciancio A. 2017. Hepatitis D, p 1409-1423. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch58
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Image of FIGURE 7

Massive splenomegaly in a patient with HDV cirrhosis (magnetic resonance of the abdomen).

Citation: Rizzetto M, Smedile A, Ciancio A. 2017. Hepatitis D, p 1409-1423. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch58
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Image of FIGURE 8

Chronic hepatitis D treated with Peg-IFN monotherapy or in combination with antivirals.

Citation: Rizzetto M, Smedile A, Ciancio A. 2017. Hepatitis D, p 1409-1423. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch58
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