Foundational Overview of HDV

CE / CME

Hepatitis Delta in Focus: A Foundational Overview of HDV

Pharmacists: 0.75 contact hour (0.075 CEUs)

Nurses: 0.75 Nursing contact hour

Physicians: Maximum of 0.75 AMA PRA Category 1 Credit

Released: December 09, 2022

Expiration: December 08, 2023

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Patient Case: Ongoing Monitoring

Let us return to our patient.

She continues to feel well. The additional testing returns: Her HBsAg is positive and her HBV DNA remains negative. In addition, her and HDV polymerase chain reaction are positive.

On repeat imaging, her right upper quadrant still has no masses, but her FibroScan is concerning for stage 4 fibrosis.

What should we do next?

The first action is that, independent of therapy, we must continue to survey her for liver cancer. Our current guidelines recommend a right upper quadrant ultrasound with or without α-fetoprotein at 6-month intervals.1

HDV therapy should be considered with or without HBV treatment. If HBV DNA is positive, it is strongly recommended to initiate HBV treatment. Since our patient is HBV DNA negative, it is difficult to decide whether to start HBV therapy in combination with HDV therapy. At the time of this writing, the guidelines do not help us navigate this gray zone.1,5,10,11