Test Catalog

Test ID: AHDV    
Hepatitis D Virus Total Antibodies, Serum

Useful For Suggests clinical disorders or settings where the test may be helpful

Detection of hepatitis D virus (HDV)-specific total antibodies (combined IgG and IgM) in human serum


Diagnosis of concurrent HDV infection in patients with fulminant acute hepatitis B virus (HBV) infection (acute coinfection), chronic HBV infection (chronic coinfection), or acute exacerbation of known chronic HBV infection (HDV superinfection)

Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Hepatitis D virus (HDV), also known as delta hepatitis virus, is a defective RNA virus comprised of a delta antigen and a hepatitis B surface antigen (HBsAg) as the core and protein coat of the virus, respectively. This virus cannot replicate effectively by itself as it requires the presence of hepatitis B virus (HBV) to initiate and maintain its replication in the infected liver cells.


Infection with HDV occurs either as an acute coinfection with HBV or an acute superinfection of chronic HBV. Acute HBV-HDV coinfection usually follows a self-limited clinical course with spontaneous resolution but may have a fulminant clinical presentation. HDV superinfection in chronic HBV or in HBV carrier state typically manifests as an acute exacerbation of chronic hepatitis B, with tendency to result in chronic HBV-HDV coinfection and early cirrhosis or liver failure. Chronic HDV infection is found in 1% of all chronically HBV-infected individuals in the United States.


Diagnosis of HDV can be established by detecting HDV antigen, HDV-specific IgM, or HDV-specific total antibodies (combined IgM and IgG) in the sera of infected patients with clinically evident acute or chronic hepatitis B. Anti-HDV IgM typically appears in serum at 2 to 3 weeks after onset of symptoms and disappears by 2 months after acute HDV infection, but it may persist up to 9 months in HDV superinfection. HDV IgG and HDV total antibodies persist in serum after resolution of acute HDV infection and in chronic coinfection.

Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.


Interpretation Provides information to assist in interpretation of the test results

This assay detects the presence of hepatitis D virus (HDV)-specific total (combined IgG and IgM) antibodies in serum.


Negative results indicate the absence of HDV infection and no past exposure to HDV.


Equivocal results indicate borderline level of anti-HDV total antibodies. Repeat testing in 1 to 2 weeks is recommended to determine the definitive HDV infection status.


Positive results usually indicate one of the following conditions: 1) simultaneous acute or chronic coinfection with hepatitis B virus (HBV) and HDV, 2) acute HDV infection in patients with known chronic HBV infection (ie, HDV superinfection), or 3) resolved HDV infection. Results should be correlated with medical history and clinical findings.


See Viral Hepatitis Serologic Profiles in Special Instructions.

Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

Negative results may not rule-out hepatitis D virus (HDV) infection during the early phase of infection or in immunocompromised patients who have delayed or inadequate immune response.


False-positive results may be due to cross-reactive antibodies from other viral infection or underlying illnesses. Positive result should be correlated with the patient's clinical history, physical examination findings, and risk factors for HDV infection.


Performance characteristics have not been established for the following specimen characteristics:

-Grossly icteric (total bilirubin level of >20 mg/dL)

-Grossly lipemic (triolein level of >3000 mg/dL)

-Grossly hemolyzed (hemoglobin level of >500 mg/dL)

-Containing particulate matter

-Cadaveric specimens

Clinical Reference Recommendations for in-depth reading of a clinical nature

1. Hughes SA, Wedemeyer H, Harrison PM: Hepatitis delta virus. Lancet. 2011;378:73-85

2. Pascarella S, Negro F: Hepatitis D virus: an update. Liver International. 2011;31(1):7-21

3. Olivero A, Smedile A: Hepatitis delta virus diagnosis. Semin Liver Dis. 2012;32:220-227

Special Instructions Library of PDFs including pertinent information and forms related to the test