Incidence
Age
Sex
Geography
Aetiology	- incomplete RNA particle enclosed in HBsAg shell - only capable of replicating in the presence of HBV - reduces active HBV synthesis - can occur as co- or super-infection
Presentation	History Co-infection - clinically the same as icteric HBV infection Super-infection - acute flare-up of previously quiescent HBV infection
Investigations	LFTs - may be biphasic rise in AST/ALT on co-infection - may be rise in AST/ALT on super-infection
Macro
Micro
Staging
Serum markers	- co-infection - serum anti-delta found in the presence of IgM anti-HBc - super-infection - serum anti-delta found in the presence of IgG anti-HBc - HDV RNA can be found in both acute and chronic infection
Management
Prognosis	- fulminant hepatitis is more common after co-infection
Complications

Hepatobiliary medicine

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