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Diagnosis and tests for hepatitis D patients
As noted above, the signs and symptoms of hepatitis D are the same as those in hepatitis B. But it is important to diagnose hepatitis D because an overlapping disease is more dangerous and aggressive. Thus, laboratory studies and imaging studies are the ones that make a difference, and sometimes doctors may also recommend histologic studies.
➤ Imaging studies
Abdominal ultrasonography is one of the most important imaging studies to evaluate the presence of liver cancer or a biliary obstruction. When a liver condition is suspected, doctors may order a cholescintigraphy. A computed tomography scan or MRI may also be useful to diagnose liver cancer.
➤ Laboratory studies
Patients suspected to be infected with hepatitis D can be tested for HDV antigens. But 80% of cases will be a false negative. A more reliable test is an HDV RNA. It is also useful to differentiate between anti-HDV IgM and IgG and check for hepatitis B infections with an anti-HB core IgM. These patients should also evaluate their liver enzymes, especially alanine aminotransferase and aspartate aminotransferase levels. Prothrombin time is also important, and very long values can be indicative of liver failure.
➤ Histologic studies
In some cases, patients need to undergo a liver biopsy, but only when hepatitis has already been diagnosed, chronic hepatitis is on course, and doctors need to rule out fibrosis, cirrhosis, or liver cancer.
