If HDV become negative

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@availlant @ThomasTu

if quantitative test comes as zero means its negative?

if HDV becomes negative, will it remain negative for life?

is there any test for HDV antibodies?

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HDV antibodies are usually used to initially diagnose that you have been exposed to HDV, so yes.

If you are HDV RNA negative, you can still have relapses of HDV infection (i.e. it can come back).

Thomas

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how do i know if my HDV is turned negative

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The current thinking in the field is that HBsAg loss (and possibly gaining anti-HBs antibodies) provides high confidence that HDV will not relapse.

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my HDV quantitative was 288,000 and then i started interferon
after 24 injections with the Grace of God, it came negative
my doctor said continue injections

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Pegylated interferon usually works quite well to suppress HDV RNA during therapy. How long have you been on therapy?

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My Anti Hbs >1000mIU/ml, and surface antigen is non reactive, with core ab total reactive. can I get hep d? should I get tested for hep d?

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if HBsAg is negative then no need to test hep d as you can never get it

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Suresh what matters now is your HBsAg.

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please explain my result, is HDV negative ?

also if you can describe me why HBsAg quantitative is necessary? i asked my consultant to do the test but he is not agreeing.

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Your HDV RNA is below the limit of quantification of the PCR test being used. This is a very good (but typical) response to pegIFN during therapy.

I don’t like the word “negative” - there is no test which can prove the absence of HDV RNA. It is also important to remember that in people who have responded well to therapy and enjoy “CURE” of HDV infection (after NAPs and or pegIFN) test “target not detected” but may still have very very small amounts of HDV RNA present but no disease and normal liver function.

Unfortunately, rebound of HDV RNA after removal of pegIFN is common but this can be to a lower level of viremia where liver function is better. Persistent undetectable HDV RNA after removal of therapy is best predicted by HBsAg loss. This can be done with a qualitative test as well. A quantitative test only makes sense if you have a previous quantitative test done before pegIFN so we could see if you are having a HBsAg response or not.

Hope this helps.

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thanks for detailed information.
no never had quantitative hbsag, but thought of doing it now and again after few months as i am still on treatment of interferon

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thank you for your reply Suresh.

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October 2022 Zero for Quantitative HDV PCR
April 2023 Zero for Quantitative HDV PCR
December 2023 Zero for Quantitative HDV PCR

Now i did Qualitative but not quantitative and it came positive.

You can see my history that i did peg INF in 2022

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Dear @Suresh786,

For the first three results, were these reported as < LLOQ or target not detected?

@availlant

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Oct 2022 Quantitative Result i am not sure if its not detected or LLOQ
May 2023 Quantitative Result “Hepatitis D RNA is not detected”
Dec 2023 Quantitative Result “Hepatitis D RNA is not detected”

My LFTs result came yesterday and it is very good results with the Grace of God

Now i have given test for Quantitative HDV again, it will take time as they send it abroad, they don’t do in the country where i am currently living and they only have facility to do qualitative which came positive. The above 3 were also done in abroad.

When is NAPs coming

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Dear @Suresh786,

There are two things to consider here:

  1. There is no qualitative HDV RNA test approved for use in the western hemisphere. It may be that your lab has one in place. In general, qualitative PCR tests can be more sensitive but they can also be prone to false positives.

  2. You should always follow your HDV RNA with an approved and preferably quantitative test (these are always more expensive however). It seems like this is what is being done in your case.

I suspect that your HDV RNA is well controlled in the absence of therapy since your LFTs are normal (this is what really counts).

@availlant

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thanks a lot, i will update you after receiving quantitative hdv from abroad lab

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if HDV is well controlled for 3 years from peg interferon, does it mean that it will remain controlled for rest of life? what can i do to keep it controlled?