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Preventing & screening for hepatitis D

🩺What information has to be gathered at the time of diagnosis?

A diagnosis allows the physician to determine the patient's condition. It is essential for decision-making (simple monitoring, treatment proposals, etc.) and is based on research identifying the cause and symptoms of the condition. During this time the patient describes his/her symptoms that helps the doctor to collect general information about the patient (treatment, history, allergies, etc.) This procedure is mainly based on 3 key phases of the medical consultation: the anamnesis, the physical examination and complementary tests.

Hepatitis D is a complex and transmissible disease, the diagnosis of which requires systematic screening of HBV patients (1).

Below mentioned information is required when dealing with a patient who is a chronic HBsAg carrier (1,2).

Is there a viral multiplication?

  • HBV DNA testing
  • HDV RNA testing
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Is the aggravation of symptoms due to the presence of a co-infection?

  • HIV and HCV serology

Is there a family history of severe liver disease?

What is the mode of transmission?

  • Background analysis
  • Risky practices and frequency
  • Information on the country of birth (help for assessing the length of the infection)
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Taking care of the entourage at risk (people living under the same roof, sexual partner, risky practices)

  • Screening
  • Vaccination

These practice recommendations are valid during an initial or follow-up visit. They are generally made monthly or quarterly during the first year of treatment and then every 6 months thereafter (3,4). Their frequency varies according to the patient's condition and medical results.

Sources

  1. Sherman M. Management of the Hepatitis B carrier. Trading all aspects of the infection. Can Fam Physician. 1992; 38: 569-570, 573-576.
  2. Terrault NA et al. AASLD Guidelines for Treatment of Chronic Hepatitis B. Hepatology 2016.
  3. Ahn J., Gish RG. Hepatitis D Virus: A Call to Screening. Gastroenterology & Hepatology. 2014; 10: 647-686.
  4. German Liver Aid eV. Hepatitis B. Page 23. https://www.leberhilfe.org/wp-content/uploads/2018/12/Brosch%C3%BCre-Hepatitis-B-dt-2018.pdf. June 2020