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id="toc-Antigenic_loop_infectivity" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Antigenic_loop_infectivity"> <div class="vector-toc-text"> <span class="vector-toc-numb">1.4</span> <span>Antigenic loop infectivity</span> </div> </a> <ul id="toc-Antigenic_loop_infectivity-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Transmission" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Transmission"> <div class="vector-toc-text"> <span class="vector-toc-numb">2</span> <span>Transmission</span> </div> </a> <ul id="toc-Transmission-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-People_at_risk" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#People_at_risk"> <div class="vector-toc-text"> <span class="vector-toc-numb">3</span> <span>People at risk</span> </div> </a> <ul id="toc-People_at_risk-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Prevention" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Prevention"> <div class="vector-toc-text"> <span class="vector-toc-numb">4</span> <span>Prevention</span> </div> </a> <ul id="toc-Prevention-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Diagnosis" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Diagnosis"> <div class="vector-toc-text"> <span class="vector-toc-numb">5</span> <span>Diagnosis</span> </div> </a> <ul id="toc-Diagnosis-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Treatment" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Treatment"> <div class="vector-toc-text"> <span class="vector-toc-numb">6</span> <span>Treatment</span> </div> </a> <ul id="toc-Treatment-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Prognosis" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Prognosis"> <div class="vector-toc-text"> <span class="vector-toc-numb">7</span> <span>Prognosis</span> </div> </a> <ul id="toc-Prognosis-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Epidemiology" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Epidemiology"> <div class="vector-toc-text"> <span class="vector-toc-numb">8</span> <span>Epidemiology</span> </div> </a> <ul id="toc-Epidemiology-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-History" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#History"> <div class="vector-toc-text"> <span class="vector-toc-numb">9</span> <span>History</span> </div> </a> <button aria-controls="toc-History-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle History subsection</span> </button> <ul id="toc-History-sublist" class="vector-toc-list"> <li id="toc-Lábrea_fever" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Lábrea_fever"> <div class="vector-toc-text"> <span class="vector-toc-numb">9.1</span> <span>Lábrea fever</span> </div> </a> <ul id="toc-Lábrea_fever-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Evolution" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Evolution"> <div class="vector-toc-text"> <span class="vector-toc-numb">10</span> <span>Evolution</span> </div> </a> <ul id="toc-Evolution-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Related_species" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Related_species"> <div class="vector-toc-text"> <span class="vector-toc-numb">11</span> <span>Related species</span> </div> </a> <ul id="toc-Related_species-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> <span class="vector-toc-numb">12</span> <span>References</span> </div> </a> <ul id="toc-References-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Bibliography" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Bibliography"> <div class="vector-toc-text"> <span class="vector-toc-numb">13</span> <span>Bibliography</span> </div> </a> <ul id="toc-Bibliography-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-External_links" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#External_links"> <div class="vector-toc-text"> <span class="vector-toc-numb">14</span> <span>External links</span> </div> </a> <ul id="toc-External_links-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Contents" class="vector-toc-landmark"> <div id="vector-page-titlebar-toc" class="vector-dropdown vector-page-titlebar-toc vector-button-flush-left" title="Table of Contents" > <input type="checkbox" id="vector-page-titlebar-toc-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-page-titlebar-toc" class="vector-dropdown-checkbox " aria-label="Toggle the table of contents" > <label id="vector-page-titlebar-toc-label" for="vector-page-titlebar-toc-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--icon-only " aria-hidden="true" ><span class="vector-icon mw-ui-icon-listBullet mw-ui-icon-wikimedia-listBullet"></span> <span class="vector-dropdown-label-text">Toggle the table of contents</span> </label> <div class="vector-dropdown-content"> <div id="vector-page-titlebar-toc-unpinned-container" class="vector-unpinned-container"> </div> </div> </div> </nav> <h1 id="firstHeading" class="firstHeading mw-first-heading"><span class="mw-page-title-main">Hepatitis D</span></h1> <div id="p-lang-btn" class="vector-dropdown mw-portlet mw-portlet-lang" > <input type="checkbox" id="p-lang-btn-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-p-lang-btn" class="vector-dropdown-checkbox mw-interlanguage-selector" aria-label="Go to an article in another language. Available in 33 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-33" aria-hidden="true" ><span class="vector-icon mw-ui-icon-language-progressive mw-ui-icon-wikimedia-language-progressive"></span> <span class="vector-dropdown-label-text">33 languages</span> </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D8%A7%D9%84%D8%AA%D9%87%D8%A7%D8%A8_%D8%A7%D9%84%D9%83%D8%A8%D8%AF_%D8%AF" title="التهاب الكبد د – Arabic" lang="ar" hreflang="ar" data-title="التهاب الكبد د" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target"><span>العربية</span></a></li><li class="interlanguage-link interwiki-az mw-list-item"><a href="https://az.wikipedia.org/wiki/Hepatit_D" title="Hepatit D – Azerbaijani" lang="az" hreflang="az" data-title="Hepatit D" data-language-autonym="Azərbaycanca" data-language-local-name="Azerbaijani" class="interlanguage-link-target"><span>Azərbaycanca</span></a></li><li class="interlanguage-link interwiki-ca mw-list-item"><a href="https://ca.wikipedia.org/wiki/Hepatitis_D" title="Hepatitis D – Catalan" lang="ca" hreflang="ca" data-title="Hepatitis D" data-language-autonym="Català" data-language-local-name="Catalan" class="interlanguage-link-target"><span>Català</span></a></li><li class="interlanguage-link interwiki-de mw-list-item"><a href="https://de.wikipedia.org/wiki/Hepatitis_D" title="Hepatitis D – German" lang="de" hreflang="de" data-title="Hepatitis D" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target"><span>Deutsch</span></a></li><li class="interlanguage-link interwiki-dv mw-list-item"><a href="https://dv.wikipedia.org/wiki/%DE%80%DE%AC%DE%95%DE%A6%DE%93%DE%A6%DE%87%DE%A8%DE%93%DE%A8%DE%90%DE%B0_%DE%91%DE%A9" title="ހެޕަޓައިޓިސް ޑީ – Divehi" lang="dv" hreflang="dv" data-title="ހެޕަޓައިޓިސް ޑީ" data-language-autonym="ދިވެހިބަސް" data-language-local-name="Divehi" class="interlanguage-link-target"><span>ދިވެހިބަސް</span></a></li><li class="interlanguage-link interwiki-et mw-list-item"><a href="https://et.wikipedia.org/wiki/D-hepatiidi_viirus" title="D-hepatiidi viirus – Estonian" lang="et" hreflang="et" data-title="D-hepatiidi viirus" data-language-autonym="Eesti" data-language-local-name="Estonian" class="interlanguage-link-target"><span>Eesti</span></a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/Hepatitis_D" title="Hepatitis D – Spanish" lang="es" hreflang="es" data-title="Hepatitis D" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target"><span>Español</span></a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%D9%87%D9%BE%D8%A7%D8%AA%DB%8C%D8%AA_%D8%AF%DB%8C" title="هپاتیت دی – Persian" lang="fa" hreflang="fa" data-title="هپاتیت دی" data-language-autonym="فارسی" data-language-local-name="Persian" class="interlanguage-link-target"><span>فارسی</span></a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/H%C3%A9patite_D" title="Hépatite D – French" lang="fr" hreflang="fr" data-title="Hépatite D" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target"><span>Français</span></a></li><li class="interlanguage-link interwiki-ko mw-list-item"><a href="https://ko.wikipedia.org/wiki/D%ED%98%95_%EA%B0%84%EC%97%BC" title="D형 간염 – Korean" lang="ko" hreflang="ko" data-title="D형 간염" data-language-autonym="한국어" data-language-local-name="Korean" class="interlanguage-link-target"><span>한국어</span></a></li><li class="interlanguage-link interwiki-hy mw-list-item"><a href="https://hy.wikipedia.org/wiki/%D5%80%D5%A5%D5%BA%D5%A1%D5%BF%D5%AB%D5%BF_D" title="Հեպատիտ D – Armenian" lang="hy" hreflang="hy" data-title="Հեպատիտ D" data-language-autonym="Հայերեն" data-language-local-name="Armenian" class="interlanguage-link-target"><span>Հայերեն</span></a></li><li class="interlanguage-link interwiki-hi mw-list-item"><a href="https://hi.wikipedia.org/wiki/%E0%A4%B9%E0%A5%88%E0%A4%AA%E0%A5%87%E0%A4%9F%E0%A4%BE%E0%A4%87%E0%A4%9F%E0%A4%BF%E0%A4%B8_%E0%A4%A1%E0%A5%80" title="हैपेटाइटिस डी – Hindi" lang="hi" hreflang="hi" data-title="हैपेटाइटिस डी" data-language-autonym="हिन्दी" data-language-local-name="Hindi" class="interlanguage-link-target"><span>हिन्दी</span></a></li><li class="interlanguage-link interwiki-id mw-list-item"><a href="https://id.wikipedia.org/wiki/Hepatitis_D" title="Hepatitis D – Indonesian" lang="id" hreflang="id" data-title="Hepatitis D" data-language-autonym="Bahasa Indonesia" data-language-local-name="Indonesian" class="interlanguage-link-target"><span>Bahasa Indonesia</span></a></li><li class="interlanguage-link interwiki-it mw-list-item"><a href="https://it.wikipedia.org/wiki/Epatite_D" title="Epatite D – Italian" lang="it" hreflang="it" data-title="Epatite D" data-language-autonym="Italiano" data-language-local-name="Italian" class="interlanguage-link-target"><span>Italiano</span></a></li><li class="interlanguage-link interwiki-he mw-list-item"><a href="https://he.wikipedia.org/wiki/Hepatitis_D_virus" title="Hepatitis D virus – Hebrew" lang="he" hreflang="he" data-title="Hepatitis D virus" data-language-autonym="עברית" data-language-local-name="Hebrew" class="interlanguage-link-target"><span>עברית</span></a></li><li class="interlanguage-link interwiki-kk mw-list-item"><a href="https://kk.wikipedia.org/wiki/%D0%92%D0%B8%D1%80%D1%83%D1%81%D1%82%D1%8B_%D0%B3%D0%B5%D0%BF%D0%B0%D1%82%D0%B8%D1%82_%D0%94" title="Вирусты гепатит Д – Kazakh" lang="kk" hreflang="kk" data-title="Вирусты гепатит Д" data-language-autonym="Қазақша" data-language-local-name="Kazakh" class="interlanguage-link-target"><span>Қазақша</span></a></li><li class="interlanguage-link interwiki-ml mw-list-item"><a href="https://ml.wikipedia.org/wiki/%E0%B4%B9%E0%B5%86%E0%B4%AA%E0%B5%8D%E0%B4%AA%E0%B4%B1%E0%B5%8D%E0%B4%B1%E0%B5%88%E0%B4%B1%E0%B5%8D%E0%B4%B1%E0%B4%BF%E0%B4%B8%E0%B5%8D-%E0%B4%A1%E0%B4%BF" title="ഹെപ്പറ്റൈറ്റിസ്-ഡി – Malayalam" lang="ml" hreflang="ml" data-title="ഹെപ്പറ്റൈറ്റിസ്-ഡി" data-language-autonym="മലയാളം" data-language-local-name="Malayalam" class="interlanguage-link-target"><span>മലയാളം</span></a></li><li class="interlanguage-link interwiki-ms mw-list-item"><a href="https://ms.wikipedia.org/wiki/Hepatitis_D" title="Hepatitis D – Malay" lang="ms" hreflang="ms" data-title="Hepatitis D" data-language-autonym="Bahasa Melayu" data-language-local-name="Malay" class="interlanguage-link-target"><span>Bahasa Melayu</span></a></li><li class="interlanguage-link interwiki-ja mw-list-item"><a href="https://ja.wikipedia.org/wiki/D%E5%9E%8B%E8%82%9D%E7%82%8E" title="D型肝炎 – Japanese" lang="ja" hreflang="ja" data-title="D型肝炎" data-language-autonym="日本語" data-language-local-name="Japanese" class="interlanguage-link-target"><span>日本語</span></a></li><li class="interlanguage-link interwiki-nn mw-list-item"><a href="https://nn.wikipedia.org/wiki/Hepatitt_D" title="Hepatitt D – Norwegian Nynorsk" lang="nn" hreflang="nn" data-title="Hepatitt D" data-language-autonym="Norsk nynorsk" data-language-local-name="Norwegian Nynorsk" class="interlanguage-link-target"><span>Norsk nynorsk</span></a></li><li class="interlanguage-link interwiki-uz mw-list-item"><a href="https://uz.wikipedia.org/wiki/Gepatit_D" title="Gepatit D – Uzbek" lang="uz" hreflang="uz" data-title="Gepatit D" data-language-autonym="Oʻzbekcha / ўзбекча" data-language-local-name="Uzbek" class="interlanguage-link-target"><span>Oʻzbekcha / ўзбекча</span></a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/Hepatite_D" title="Hepatite D – Portuguese" lang="pt" hreflang="pt" data-title="Hepatite D" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target"><span>Português</span></a></li><li class="interlanguage-link interwiki-ro mw-list-item"><a href="https://ro.wikipedia.org/wiki/Hepatit%C4%83_D" title="Hepatită D – Romanian" lang="ro" hreflang="ro" data-title="Hepatită D" data-language-autonym="Română" data-language-local-name="Romanian" class="interlanguage-link-target"><span>Română</span></a></li><li class="interlanguage-link interwiki-ru badge-Q17559452 badge-recommendedarticle mw-list-item" title="recommended article"><a href="https://ru.wikipedia.org/wiki/%D0%93%D0%B5%D0%BF%D0%B0%D1%82%D0%B8%D1%82_D" title="Гепатит D – Russian" lang="ru" hreflang="ru" data-title="Гепатит D" data-language-autonym="Русский" data-language-local-name="Russian" class="interlanguage-link-target"><span>Русский</span></a></li><li class="interlanguage-link interwiki-simple mw-list-item"><a href="https://simple.wikipedia.org/wiki/Hepatitis_D" title="Hepatitis D – Simple English" lang="en-simple" hreflang="en-simple" data-title="Hepatitis D" data-language-autonym="Simple English" data-language-local-name="Simple English" class="interlanguage-link-target"><span>Simple English</span></a></li><li class="interlanguage-link interwiki-sl mw-list-item"><a href="https://sl.wikipedia.org/wiki/Hepatitis_D" title="Hepatitis D – Slovenian" lang="sl" hreflang="sl" data-title="Hepatitis D" data-language-autonym="Slovenščina" data-language-local-name="Slovenian" class="interlanguage-link-target"><span>Slovenščina</span></a></li><li class="interlanguage-link interwiki-sr mw-list-item"><a href="https://sr.wikipedia.org/wiki/%D0%A5%D0%B5%D0%BF%D0%B0%D1%82%D0%B8%D1%82%D0%B8%D1%81_%D0%94" title="Хепатитис Д – Serbian" lang="sr" hreflang="sr" data-title="Хепатитис Д" data-language-autonym="Српски / srpski" data-language-local-name="Serbian" class="interlanguage-link-target"><span>Српски / srpski</span></a></li><li class="interlanguage-link interwiki-sv mw-list-item"><a href="https://sv.wikipedia.org/wiki/Hepatit_D" title="Hepatit D – Swedish" lang="sv" hreflang="sv" data-title="Hepatit D" data-language-autonym="Svenska" data-language-local-name="Swedish" class="interlanguage-link-target"><span>Svenska</span></a></li><li class="interlanguage-link interwiki-tl mw-list-item"><a href="https://tl.wikipedia.org/wiki/Hepatitis_D" title="Hepatitis D – Tagalog" lang="tl" hreflang="tl" data-title="Hepatitis D" data-language-autonym="Tagalog" data-language-local-name="Tagalog" class="interlanguage-link-target"><span>Tagalog</span></a></li><li class="interlanguage-link interwiki-tr mw-list-item"><a href="https://tr.wikipedia.org/wiki/Hepatit_D" title="Hepatit D – Turkish" lang="tr" hreflang="tr" data-title="Hepatit D" data-language-autonym="Türkçe" data-language-local-name="Turkish" class="interlanguage-link-target"><span>Türkçe</span></a></li><li class="interlanguage-link interwiki-uk mw-list-item"><a href="https://uk.wikipedia.org/wiki/%D0%93%D0%B5%D0%BF%D0%B0%D1%82%D0%B8%D1%82_D" title="Гепатит D – Ukrainian" lang="uk" hreflang="uk" data-title="Гепатит D" data-language-autonym="Українська" data-language-local-name="Ukrainian" class="interlanguage-link-target"><span>Українська</span></a></li><li class="interlanguage-link interwiki-ur mw-list-item"><a href="https://ur.wikipedia.org/wiki/%DB%81%DB%8C%D9%BE%D8%A7%D9%B9%D8%A7%D8%A6%D9%B9%D8%B3_%DA%88%DB%8C" title="ہیپاٹائٹس ڈی – Urdu" lang="ur" hreflang="ur" data-title="ہیپاٹائٹس ڈی" data-language-autonym="اردو" data-language-local-name="Urdu" class="interlanguage-link-target"><span>اردو</span></a></li><li class="interlanguage-link interwiki-zh mw-list-item"><a href="https://zh.wikipedia.org/wiki/%E4%B8%81%E5%9E%8B%E8%82%9D%E7%82%8E" title="丁型肝炎 – Chinese" lang="zh" hreflang="zh" data-title="丁型肝炎" data-language-autonym="中文" data-language-local-name="Chinese" class="interlanguage-link-target"><span>中文</span></a></li> </ul> <div class="after-portlet after-portlet-lang"><span class="wb-langlinks-edit wb-langlinks-link"><a href="https://www.wikidata.org/wiki/Special:EntityPage/Q327281#sitelinks-wikipedia" title="Edit interlanguage links" class="wbc-editpage">Edit links</a></span></div> </div> </div> </div> </header> <div class="vector-page-toolbar"> <div class="vector-page-toolbar-container"> <div id="left-navigation"> <nav aria-label="Namespaces"> <div id="p-associated-pages" class="vector-menu vector-menu-tabs mw-portlet mw-portlet-associated-pages" > <div 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</div> </div> <div id="bodyContent" class="vector-body" aria-labelledby="firstHeading" data-mw-ve-target-container> <div class="vector-body-before-content"> <div class="mw-indicators"> </div> <div id="siteSub" class="noprint">From Wikipedia, the free encyclopedia</div> </div> <div id="contentSub"><div id="mw-content-subtitle"></div></div> <div id="mw-content-text" class="mw-body-content"><div class="mw-content-ltr mw-parser-output" lang="en" dir="ltr"><div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Human infectious disease</div> <div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Medical condition</div><style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox 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colspan="2" class="infobox-above" style="background:#ccc">Hepatitis D</th></tr><tr><th scope="row" class="infobox-label">Other names</th><td class="infobox-data">Hepatitis delta</td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_specialty" title="Medical specialty">Specialty</a></th><td class="infobox-data"><a href="/wiki/Gastroenterology" title="Gastroenterology">Gastroenterology</a>, <a href="/wiki/Infectious_disease" class="mw-redirect" title="Infectious disease">infectious disease</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Signs_and_symptoms" title="Signs and symptoms">Symptoms</a></th><td class="infobox-data">Feeling tired, nausea and vomiting<sup id="cite_ref-n_1-0" class="reference"><a href="#cite_note-n-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Complication_(medicine)" title="Complication (medicine)">Complications</a></th><td class="infobox-data">Cirrhosis<sup id="cite_ref-n_1-1" class="reference"><a href="#cite_note-n-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Causes</th><td class="infobox-data">Hepatitis D virus<sup id="cite_ref-n_1-2" class="reference"><a href="#cite_note-n-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_diagnosis" title="Medical diagnosis">Diagnostic method</a></th><td class="infobox-data">Immunoglobulin G<sup id="cite_ref-hd_2-0" class="reference"><a href="#cite_note-hd-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Treatment</th><td class="infobox-data">Antivirals, pegylated interferon alpha<sup id="cite_ref-hd_2-1" class="reference"><a href="#cite_note-hd-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medication" title="Medication">Medication</a></th><td class="infobox-data"><a href="/wiki/Bulevirtide" title="Bulevirtide">Bulevirtide</a></td></tr></tbody></table><style data-mw-deduplicate="TemplateStyles:r1236303919">@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-has-images-with-white-backgrounds img{background:white}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-has-images-with-white-backgrounds img{background:white}}</style> <p><b>Hepatitis D</b> is a type of <a href="/wiki/Viral_hepatitis" title="Viral hepatitis">viral hepatitis</a><sup id="cite_ref-3" class="reference"><a href="#cite_note-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> caused by the <b>hepatitis delta virus</b> (<b>HDV</b>).<sup id="cite_ref-pmid14708706_4-0" class="reference"><a href="#cite_note-pmid14708706-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-5" class="reference"><a href="#cite_note-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> HDV is one of five known <a href="/wiki/Hepatitis" title="Hepatitis">hepatitis</a> viruses: <a href="/wiki/Hepatitis_A" title="Hepatitis A">A</a>, <a href="/wiki/Hepatitis_B" title="Hepatitis B">B</a>, <a href="/wiki/Hepatitis_C" title="Hepatitis C">C</a>, D, and <a href="/wiki/Hepatitis_E" title="Hepatitis E">E</a>. HDV is considered to be a <a href="/wiki/Satellite_(biology)" title="Satellite (biology)">satellite</a> (a type of <a href="/wiki/Subviral_agent" class="mw-redirect" title="Subviral agent">subviral agent</a>) because it can propagate only in the presence of the <a href="/wiki/Hepatitis_B" title="Hepatitis B">hepatitis B virus</a> (HBV).<sup id="cite_ref-6" class="reference"><a href="#cite_note-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> Transmission of HDV can occur either via simultaneous infection with HBV (<a href="/wiki/Coinfection" title="Coinfection">coinfection</a>) or superimposed on chronic hepatitis B or hepatitis B carrier state (<a href="/wiki/Superinfection" title="Superinfection">superinfection</a>). </p><p>HDV infecting a person with chronic hepatitis B (superinfection) is considered the most serious type of viral hepatitis due to its severity of complications.<sup id="cite_ref-7" class="reference"><a href="#cite_note-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> These complications include a greater likelihood of experiencing liver failure in acute infections and a rapid progression to liver <a href="/wiki/Cirrhosis" title="Cirrhosis">cirrhosis</a>, with an increased risk of developing <a href="/wiki/Liver_cancer" title="Liver cancer">liver cancer</a> in chronic infections.<sup id="cite_ref-8" class="reference"><a href="#cite_note-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> In combination with hepatitis B virus, hepatitis D has the highest fatality rate of all the hepatitis infections, at 20%. A recent estimate from 2020 suggests that currently 48 million people are infected with this virus.<sup id="cite_ref-9" class="reference"><a href="#cite_note-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> </p> <table class="wikitable"> <caption> </caption> <tbody><tr> <th> </th> <th>Hepatitis D </th></tr> <tr> <td>Synonym </td> <td>Delta hepatitis </td></tr> <tr> <td>Type of Virus </td> <td>ssRNA </td></tr> <tr> <td>Incubation Period </td> <td>2–12 weeks </td></tr> <tr> <td>Transmission </td> <td>Parenteral </td></tr> <tr> <td>Carrier State </td> <td>Yes </td></tr> <tr> <td>Immunity <p>Passive immunization </p><p>Active immunization </p> </td> <td>Hyperimmune globulin <p>Vaccine (hepatitis B) </p> </td></tr></tbody></table> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Virology">Virology</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hepatitis_D&action=edit&section=1" title="Edit section: Virology"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <table class="infobox biota" style="text-align: left; width: 200px; font-size: 100%"> <tbody><tr> <th colspan="2" style="color:inherit; text-align: center; background-color: rgb(250,250,190)">Hepatitis delta virus </th></tr> <tr> <td colspan="2" style="text-align: center"><span class="mw-default-size" typeof="mw:File/Frameless"><a href="/wiki/File:Hepatitis-d-virion-Pathogens-04-00046-g001-1024.png" class="mw-file-description"><img alt="Schematic representation of the "Hepatitis delta virus" virion" src="//upload.wikimedia.org/wikipedia/commons/thumb/d/d4/Hepatitis-d-virion-Pathogens-04-00046-g001-1024.png/220px-Hepatitis-d-virion-Pathogens-04-00046-g001-1024.png" decoding="async" width="220" height="156" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/d/d4/Hepatitis-d-virion-Pathogens-04-00046-g001-1024.png/330px-Hepatitis-d-virion-Pathogens-04-00046-g001-1024.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/d/d4/Hepatitis-d-virion-Pathogens-04-00046-g001-1024.png/440px-Hepatitis-d-virion-Pathogens-04-00046-g001-1024.png 2x" data-file-width="1024" data-file-height="728" /></a></span> </td></tr> <tr> <td colspan="2" style="text-align: center; font-size: 88%">Schematic representation of the <i>Hepatitis delta virus</i> virion </td></tr> <tr> <th colspan="2" style="color:inherit; min-width:15em; text-align: center; background-color: rgb(250,250,190)"><a href="/wiki/Virus_classification" title="Virus classification">Virus classification</a> <span class="plainlinks taxobox-edit-taxonomy skin-invert" style="font-size:smaller; float:right; padding-right:0.4em; margin-left:-3em;"><span typeof="mw:File"><a href="/wiki/Template:Taxonomy/Deltavirus" title="Edit this classification"><img alt="Edit this classification" src="//upload.wikimedia.org/wikipedia/commons/thumb/8/8a/OOjs_UI_icon_edit-ltr.svg/15px-OOjs_UI_icon_edit-ltr.svg.png" decoding="async" width="15" height="15" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/8/8a/OOjs_UI_icon_edit-ltr.svg/23px-OOjs_UI_icon_edit-ltr.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/8/8a/OOjs_UI_icon_edit-ltr.svg/30px-OOjs_UI_icon_edit-ltr.svg.png 2x" data-file-width="20" data-file-height="20" /></a></span></span> </th></tr> <tr> <td>(unranked): </td> <td><a href="/wiki/Virus" title="Virus">Virus</a> </td></tr> <tr> <td><i>Realm</i>: </td> <td><a href="/wiki/Ribozyviria" title="Ribozyviria"><i>Ribozyviria</i></a> </td></tr> <tr> <td>Family: </td> <td><a href="/wiki/Ribozyviria" title="Ribozyviria"><i>Kolmioviridae</i></a> </td></tr> <tr> <td>Genus: </td> <td><b><i>Deltavirus</i></b> </td></tr> <tr> <th colspan="2" style="color:inherit; text-align: center; background-color: rgb(250,250,190)">Species<sup id="cite_ref-Deltavirus_10-0" class="reference"><a href="#cite_note-Deltavirus-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> </th></tr> <tr> <td colspan="2" style="text-align: left"> <ul><li><i>Deltavirus cameroonense</i> [HDV-7]</li> <li><i>Deltavirus carense</i> [HDV-6]</li> <li><i>Deltavirus italiense</i> [HDV-1]</li> <li><i>Deltavirus japanense</i> [HDV-2]</li> <li><i>Deltavirus peruense</i> [HDV-3]</li> <li><i>Deltavirus senegalense</i> [HDV-8]</li> <li><i>Deltavirus taiwanense</i> [HDV-4]</li> <li><i>Deltavirus togense</i> [HDV-5]</li></ul> </td></tr> </tbody></table><style data-mw-deduplicate="TemplateStyles:r1238732961">@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox.biota tr{background:transparent!important}html.skin-theme-clientpref-night .mw-parser-output .infobox.biota img{background:transparent}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox.biota tr{background:transparent!important}html.skin-theme-clientpref-os .mw-parser-output .infobox.biota img{background:white}}.mw-parser-output .infobox.biota .taxobox-edit-taxonomy img{background:transparent!important}body.skin-vector .mw-parser-output table.biota.infobox{margin-top:0.5em}body.skin--responsive .mw-parser-output table.biota.infobox tr.taxonrow td{padding:2px 10px}</style> <div class="mw-heading mw-heading3"><h3 id="Structure_and_genome">Structure and genome</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hepatitis_D&action=edit&section=2" title="Edit section: Structure and genome"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The hepatitis delta viruses, or HDV, are eight species of <a href="/wiki/Sense_(molecular_biology)" title="Sense (molecular biology)">negative-sense</a> single-stranded <a href="/wiki/RNA_virus" title="RNA virus">RNA viruses</a> (or virus-like particles) classified together as the genus <i>Deltavirus</i>, within the realm <i><a href="/wiki/Ribozyviria" title="Ribozyviria">Ribozyviria</a></i>.<sup id="cite_ref-ictv_11-0" class="reference"><a href="#cite_note-ictv-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> The HDV virion is a small, spherical, enveloped particle with a 36 nm diameter; its <a href="/wiki/Viral_envelope" title="Viral envelope">viral envelope</a> contains host phospholipids, as well as three proteins taken from the hepatitis B virus—the large, medium, and small hepatitis B surface antigens. This assembly surrounds an inner ribonucleoprotein (RNP) particle, which contains the genome surrounded by about 200 molecules of hepatitis D antigen (HDAg) for each genome. The central region of HDAg has been shown to bind RNA.<sup id="cite_ref-pmid8245865_12-0" class="reference"><a href="#cite_note-pmid8245865-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> Several interactions are also mediated by a <a href="/wiki/Coiled_coil" title="Coiled coil">coiled-coil</a> region at the <a href="/wiki/N_terminus" class="mw-redirect" title="N terminus">N terminus</a> of HDAg.<sup id="cite_ref-pmid9687364_13-0" class="reference"><a href="#cite_note-pmid9687364-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-14" class="reference"><a href="#cite_note-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> </p><p>The HDV genome is <a href="/wiki/Sense_(molecular_biology)" title="Sense (molecular biology)">negative sense</a>, single-stranded, <a href="/wiki/Circular_RNA" title="Circular RNA">closed circular RNA</a>; with a genome of approximately 1700 nucleotides, HDV is the smallest "virus" known to infect animals. It has been proposed that HDV may have originated from a class of plant pathogens called <a href="/wiki/Viroids" class="mw-redirect" title="Viroids">viroids</a>, which are much smaller than viruses.<sup id="cite_ref-15" class="reference"><a href="#cite_note-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-16" class="reference"><a href="#cite_note-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup> Its genome is unique among animal viruses because of its high GC nucleotide content. Its nucleotide sequence is about 70% self-complementary, allowing the genome to form a partially double-stranded, rod-like RNA structure.<sup id="cite_ref-17" class="reference"><a href="#cite_note-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup> HDV strains are highly divergent; fusions of different strains exist and sequences had been deposited in public databases employing different start sites for the circular viral RNA involved. This had resulted in something of chaos with respect to molecular classification of this virus, a situation which has been resolved recently with the adoption of a proposed reference genome and a uniform classification system.<sup id="cite_ref-18" class="reference"><a href="#cite_note-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Life_cycle">Life cycle</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hepatitis_D&action=edit&section=3" title="Edit section: Life cycle"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Like hepatitis B, HDV gains entry into liver cells via the <a href="/wiki/SLC10A1" class="mw-redirect" title="SLC10A1">sodium taurocholate cotransporting polypeptide (NTCP)</a><sup id="cite_ref-pmid23150796_19-0" class="reference"><a href="#cite_note-pmid23150796-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup> bile transporter. HDV recognizes its receptor via the N-terminal domain of the large hepatitis B surface antigen, <a href="/wiki/HBsAg" title="HBsAg">HBsAg</a>.<sup id="cite_ref-20" class="reference"><a href="#cite_note-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup> Mapping by mutagenesis of this domain has shown that amino acid residues 9–15 make up the receptor-binding site.<sup id="cite_ref-21" class="reference"><a href="#cite_note-21"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup> After entering the hepatocyte, the virus is uncoated and the nucleocapsid translocated to the nucleus due to a signal in HDAg.<sup id="cite_ref-22" class="reference"><a href="#cite_note-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup> Since the HDV genome does not code for an RNA polymerase to replicate the virus' genome, the virus makes use of the host cellular <a href="/wiki/RNA_polymerase" title="RNA polymerase">RNA polymerases</a>. Initially thought to use just RNA polymerase II,<sup id="cite_ref-23" class="reference"><a href="#cite_note-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-24" class="reference"><a href="#cite_note-24"><span class="cite-bracket">[</span>24<span class="cite-bracket">]</span></a></sup> now RNA polymerases I and III have also been shown to be involved in HDV replication.<sup id="cite_ref-25" class="reference"><a href="#cite_note-25"><span class="cite-bracket">[</span>25<span class="cite-bracket">]</span></a></sup> Normally RNA polymerase II utilizes DNA as a template and produces mRNA. Consequently, if HDV indeed utilizes RNA polymerase II during replication, it would be the only known animal pathogen capable of using a DNA-dependent polymerase as an RNA-dependent polymerase.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (February 2020)">citation needed</span></a></i>]</sup> </p><p>The RNA polymerases treat the RNA genome as double-stranded DNA due to the folded rod-like structure it is in. Three forms of RNA are made; circular genomic RNA, circular complementary <a href="/wiki/Antigenome" title="Antigenome">antigenomic</a> RNA, and a linear polyadenylated antigenomic RNA, which is the mRNA containing the open reading frame for the HDAg. Synthesis of antigenomic RNA occurs in the nucleolus, mediated by RNA polymerase I, whereas synthesis of genomic RNA takes place in the nucleoplasm, mediated by RNA polymerase II.<sup id="cite_ref-26" class="reference"><a href="#cite_note-26"><span class="cite-bracket">[</span>26<span class="cite-bracket">]</span></a></sup> HDV RNA is synthesized first as linear RNA that contains many copies of the genome. The genomic and antigenomic RNA contain a sequence of 85 nucleotides, the <a href="/wiki/Hepatitis_delta_virus_ribozyme" title="Hepatitis delta virus ribozyme">hepatitis delta virus ribozyme</a>, that acts as a <a href="/wiki/Ribozyme" title="Ribozyme">ribozyme</a>, which self-cleaves the linear RNA into monomers. These monomers are then ligated to form circular RNA.<sup id="cite_ref-27" class="reference"><a href="#cite_note-27"><span class="cite-bracket">[</span>27<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-28" class="reference"><a href="#cite_note-28"><span class="cite-bracket">[</span>28<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Delta_antigens">Delta antigens</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hepatitis_D&action=edit&section=4" title="Edit section: Delta antigens"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Protein family</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1257001546"><table class="infobox"><tbody><tr><th colspan="2" class="infobox-above">Hepatitis delta virus delta antigen</th></tr><tr><td colspan="2" class="infobox-image"><span class="mw-default-size" typeof="mw:File/Frameless"><a href="/wiki/File:PDB_1a92_EBI.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/d/df/PDB_1a92_EBI.jpg/220px-PDB_1a92_EBI.jpg" decoding="async" width="220" height="149" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/d/df/PDB_1a92_EBI.jpg/330px-PDB_1a92_EBI.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/d/df/PDB_1a92_EBI.jpg/440px-PDB_1a92_EBI.jpg 2x" data-file-width="560" data-file-height="380" /></a></span><div class="infobox-caption">oligomerization domain of hepatitis delta antigen</div></td></tr><tr><th colspan="2" class="infobox-header" style="background-color: #ddd; color:inherit;">Identifiers</th></tr><tr><th scope="row" class="infobox-label" style="background-color: #e7dcc3; color:inherit;">Symbol</th><td class="infobox-data" style="background-color: #eee; color:inherit;">HDV_ag</td></tr><tr><th scope="row" class="infobox-label" style="background-color: #e7dcc3; color:inherit;"><a href="/wiki/Pfam" title="Pfam">Pfam</a></th><td class="infobox-data pfam" style="background-color: #eee; color:inherit;"><a rel="nofollow" class="external text" href="https://www.ebi.ac.uk/interpro/entry/pfam/PF01517">PF01517</a></td></tr><tr><th scope="row" class="infobox-label" style="background-color: #e7dcc3; color:inherit;"><a href="/wiki/InterPro" title="InterPro">InterPro</a></th><td class="infobox-data" style="background-color: #eee; color:inherit;"><a rel="nofollow" class="external text" href="https://www.ebi.ac.uk/interpro/entry/IPR002506">IPR002506</a></td></tr><tr><th scope="row" class="infobox-label" style="background-color: #e7dcc3; color:inherit;"><a href="/wiki/Structural_Classification_of_Proteins" class="mw-redirect" title="Structural Classification of Proteins">SCOP2</a></th><td class="infobox-data" style="background-color: #eee; color:inherit;"><a rel="nofollow" class="external text" href="http://scop2.mrc-lmb.cam.ac.uk/search?t=txt;q=1a92">1a92</a> / <a rel="nofollow" class="external text" href="https://scop.berkeley.edu/pdb/code=1a92">SCOPe</a> / <a rel="nofollow" class="external text" href="http://supfam.org/SUPERFAMILY/cgi-bin/search.cgi?search_field=1a92">SUPFAM</a></td></tr><tr><td colspan="2" class="infobox-full-data" style="background-color: #eee; color:inherit;"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1257001546"><table class="infobox mw-collapsible mw-collapsed" style="float:none; clear:none; margin:0; border-width:0; border-collapse:collapse; text-align:left; width:100%"><tbody><tr><th colspan="2" class="infobox-header" style="background-color: #ddd; color:inherit;">Available protein structures:</th></tr><tr><th scope="row" class="infobox-label" style="background-color: #e7dcc3; color:inherit; border:#fafafa 2px solid; border-width:3px 2px 0 0;"><a href="/wiki/Pfam" title="Pfam">Pfam</a>  </th><td class="infobox-data" style="background-color: #eee; color:inherit; border:#fafafa 2px solid; border-width:3px 0 0 2px;"><a rel="nofollow" class="external text" href="http://pfam.xfam.org/family/PF01517?tab=pdbBlock">structures</a> / <a rel="nofollow" class="external text" href="http://prodata.swmed.edu/ecod/complete/search?kw=PF01517">ECOD</a>  </td></tr><tr><th scope="row" class="infobox-label" style="background-color: #e7dcc3; color:inherit; border:#fafafa 2px solid; border-width:3px 2px 0 0;"><a href="/wiki/Protein_Data_Bank" title="Protein Data Bank">PDB</a></th><td class="infobox-data" style="background-color: #eee; color:inherit; border:#fafafa 2px solid; border-width:3px 0 0 2px;"><a rel="nofollow" class="external text" href="https://www.rcsb.org/search?q=rcsb_polymer_entity_annotation.annotation_id:PF01517%20AND%20rcsb_polymer_entity_annotation.type:Pfam">RCSB PDB</a>; <a rel="nofollow" class="external text" href="https://www.ebi.ac.uk/pdbe/entry/search/index?pfam_accession:PF01517">PDBe</a>; <a rel="nofollow" class="external text" href="https://pdbj.org/search/pdb?other_db_select=PFam&other_db_field=PF01517">PDBj</a></td></tr><tr><th scope="row" class="infobox-label" style="background-color: #e7dcc3; color:inherit; border:#fafafa 2px solid; border-width:3px 2px 0 0;"><a href="/wiki/PDBsum" title="PDBsum">PDBsum</a></th><td class="infobox-data" style="background-color: #eee; color:inherit; border:#fafafa 2px solid; border-width:3px 0 0 2px;"><a rel="nofollow" class="external text" href="https://www.ebi.ac.uk/thornton-srv/databases/cgi-bin/pdbsum/GetPfamStr.pl?pfam_id=PF01517">structure summary</a></td></tr></tbody></table></td></tr></tbody></table> <p>A significant difference between <a href="/wiki/Viroids" class="mw-redirect" title="Viroids">viroids</a> and HDV is that, while viroids produce no proteins, HDV is known to produce one protein, namely HDAg. It comes in two forms; a 27kDa large-HDAg, and a small-HDAg of 24kDa. The N-terminals of the two forms are identical, they differ by 19 more amino acids in the C-terminal of the large HDAg.<sup id="cite_ref-Weiner1988_29-0" class="reference"><a href="#cite_note-Weiner1988-29"><span class="cite-bracket">[</span>29<span class="cite-bracket">]</span></a></sup> Both isoforms are produced from the same reading frame which contains an UAG stop codon at codon 196, which normally produces only the small-HDAg. However, editing by cellular enzyme <a href="/wiki/ADAR#Enzyme_classification" title="ADAR">adenosine deaminase acting on RNA (ADAR)</a> changes the stop codon to UGG, allowing the large-HDAg to be produced.<sup id="cite_ref-Weiner1988_29-1" class="reference"><a href="#cite_note-Weiner1988-29"><span class="cite-bracket">[</span>29<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-30" class="reference"><a href="#cite_note-30"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup> Despite having 90% identical sequences, these two proteins play diverging roles during the course of an infection. HDAg-S is produced in the early stages of an infection and enters the nucleus and supports viral replication. HDAg-L, in contrast, is produced during the later stages of an infection, acts as an inhibitor of viral replication, and is required for assembly of viral particles.<sup id="cite_ref-31" class="reference"><a href="#cite_note-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-32" class="reference"><a href="#cite_note-32"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-33" class="reference"><a href="#cite_note-33"><span class="cite-bracket">[</span>33<span class="cite-bracket">]</span></a></sup> Thus RNA editing by the cellular enzymes is critical to the virus' life cycle because it regulates the balance between viral replication and virion assembly.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (January 2021)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading3"><h3 id="Antigenic_loop_infectivity">Antigenic loop infectivity</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hepatitis_D&action=edit&section=5" title="Edit section: Antigenic loop infectivity"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The HDV envelope protein has three of the HBV surface proteins anchored to it. The S region of the genome is most commonly expressed and its main function is to assemble subviral particles. HDV antigen proteins combine with the viral genome to form a ribonucleoprotein (RNP) which when enveloped with the subviral particles can form viral-like particles that are almost identical to mature HDV, but they are not infectious. Researchers had concluded that the determinant of infectivity of HDV was within the N-terminal pre-S1 domain of the large protein (L). It was found to be a mediator in binding to the cellular receptor. Researchers Georges Abou Jaoudé and Camille Sureau published an article in 2005 that studied the role of the antigenic loop, found in HDV envelope proteins, in the infectivity of the virus. The antigenic loop, like the N-terminal pre-S1 domain of the large protein, is exposed at the virion surface. Jaoudé and Sureau's study provided evidence that the antigenic loop may be an important factor in HDV entry into the host cell and by mutating parts of the antigenic loop, the infectivity of HDV may be minimized.<sup id="cite_ref-34" class="reference"><a href="#cite_note-34"><span class="cite-bracket">[</span>34<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Transmission">Transmission</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hepatitis_D&action=edit&section=6" title="Edit section: Transmission"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The routes of transmission of hepatitis D are similar to those for hepatitis B. Infection is largely restricted to persons at high risk of hepatitis B infection, particularly injecting drug users and persons receiving clotting factor concentrates. Worldwide more than 15 million people are co-infected. HDV is rare in most <a href="/wiki/Developed_country" title="Developed country">developed countries</a>, and is mostly associated with <a href="/wiki/Drug_injection" title="Drug injection">intravenous drug use</a>. However, HDV is much more common in the immediate Mediterranean region, sub-Saharan Africa, the Middle East, and the northern part of South America.<sup id="cite_ref-Radjef2004_35-0" class="reference"><a href="#cite_note-Radjef2004-35"><span class="cite-bracket">[</span>35<span class="cite-bracket">]</span></a></sup> In all, about 20 million people may be infected with HDV.<sup id="cite_ref-36" class="reference"><a href="#cite_note-36"><span class="cite-bracket">[</span>36<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="People_at_risk">People at risk</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hepatitis_D&action=edit&section=7" title="Edit section: People at risk"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>As previously stated, patients previously diagnosed with hepatitis B are at risk for hepatitis D infection. Hepatitis D infection risk increases if a person uses injecting drugs, is a hemophiliac, if they are a hemodialysis patient, or through sexual contact with other infected persons. </p> <div class="mw-heading mw-heading2"><h2 id="Prevention">Prevention</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hepatitis_D&action=edit&section=8" title="Edit section: Prevention"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Vaccination against hepatitis B protects against hepatitis D viral infection as hepatitis D requires hepatitis B viral infection to be present in order to infect and replicate in people.<sup id="cite_ref-37" class="reference"><a href="#cite_note-37"><span class="cite-bracket">[</span>37<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-38" class="reference"><a href="#cite_note-38"><span class="cite-bracket">[</span>38<span class="cite-bracket">]</span></a></sup> Universal vaccination against hepatitis B virus is recommended by the <a href="/wiki/World_Health_Organization" title="World Health Organization">World Health Organization</a>. The hepatitis B vaccine is routinely given soon after birth (usually within 24 hours) to protect against hepatitis B and D viral infection.<sup id="cite_ref-WHO_HBV_39-0" class="reference"><a href="#cite_note-WHO_HBV-39"><span class="cite-bracket">[</span>39<span class="cite-bracket">]</span></a></sup> </p><p>Latex or polyurethane <a href="/wiki/Condoms" class="mw-redirect" title="Condoms">condoms</a> have been shown to prevent the transmission of hepatitis B, and most likely hepatitis D viral infection.<sup id="cite_ref-American_Liver_Foundation_40-0" class="reference"><a href="#cite_note-American_Liver_Foundation-40"><span class="cite-bracket">[</span>40<span class="cite-bracket">]</span></a></sup> </p><p>Women who are pregnant or trying to become pregnant should undergo testing for HBV to know if they carry the virus, this will allow prevention strategies to be implemented during the birth of the child. The CDC recommends that all women who are pregnant be tested for hepatitis B viral infection and that all infants of women with HBV infection be given <a href="/wiki/Hepatitis_B_immune_globulin" title="Hepatitis B immune globulin">hepatitis B immune globulin</a> (HBIG) and the <a href="/wiki/Hepatitis_B_vaccine" title="Hepatitis B vaccine">hepatitis B vaccine</a> within 12 hours of birth to prevent transmission of the virus from mother to child.<sup id="cite_ref-CDC_1_41-0" class="reference"><a href="#cite_note-CDC_1-41"><span class="cite-bracket">[</span>41<span class="cite-bracket">]</span></a></sup> </p><p>Those who get <a href="/wiki/Tattoos" class="mw-redirect" title="Tattoos">tattoos</a> or <a href="/wiki/Body_piercings" class="mw-redirect" title="Body piercings">body piercings</a> should do so using sterile equipment to prevent the transmission of hepatitis B and D via infected bodily fluids. Hepatitis B and D can also be transmitted from contaminated needles, so those who inject drugs should seek help to stop drug use or use sterile needles and avoid sharing needles with others.<sup id="cite_ref-American_Liver_Foundation_40-1" class="reference"><a href="#cite_note-American_Liver_Foundation-40"><span class="cite-bracket">[</span>40<span class="cite-bracket">]</span></a></sup> Those with hepatitis B or D should also not share <a href="/wiki/Razors" class="mw-redirect" title="Razors">razors</a> or other personal care items which may have been contaminated by potentially infectious bodily fluids.<sup id="cite_ref-American_Liver_Foundation_40-2" class="reference"><a href="#cite_note-American_Liver_Foundation-40"><span class="cite-bracket">[</span>40<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Diagnosis">Diagnosis</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hepatitis_D&action=edit&section=9" title="Edit section: Diagnosis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Screening for hepatits D requires testing for anti-HDV antibodies, which indicate past exposure to the virus or current infection. If anti-HDV antibodies are present, then active HDV infection is confirmed by measuring hepatitis D RNA levels.<sup id="cite_ref-Asselah_2023_42-0" class="reference"><a href="#cite_note-Asselah_2023-42"><span class="cite-bracket">[</span>42<span class="cite-bracket">]</span></a></sup> Testing for HDV is only indicated in those who are hepatitis B surface antigen positive (those who have had previous or active infection with hepatitis B) as HDV requires hepatitis B viral infection to infect people.<sup id="cite_ref-Asselah_2023_42-1" class="reference"><a href="#cite_note-Asselah_2023-42"><span class="cite-bracket">[</span>42<span class="cite-bracket">]</span></a></sup> Non-invasive measures of liver fibrosis, such as the biomarker based <a href="/wiki/FibroTest" title="FibroTest">FibroTest</a> or non-invasive liver imaging such as <a href="/wiki/Transient_elastography" class="mw-redirect" title="Transient elastography">transient elastography</a> (also known as the FibroScan) have not been validated as quantitative measures of liver fibrosis in those with chronic hepatitis D infection. In those with whom liver fibrosis or cirrhosis is suspected, a liver biopsy is usually needed.<sup id="cite_ref-Asselah_2023_42-2" class="reference"><a href="#cite_note-Asselah_2023-42"><span class="cite-bracket">[</span>42<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Treatment">Treatment</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hepatitis_D&action=edit&section=10" title="Edit section: Treatment"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Current established treatments for chronic hepatitis D include conventional or <a href="/wiki/Pegylated_interferon_alpha" class="mw-redirect" title="Pegylated interferon alpha">pegylated interferon alpha</a> therapy.<sup id="cite_ref-43" class="reference"><a href="#cite_note-43"><span class="cite-bracket">[</span>43<span class="cite-bracket">]</span></a></sup> Evidence suggests that pegylated interferon alpha is effective in reducing the viral load and the effect of the disease during the time the drug is given, but the benefit generally stops if the drug is discontinued.<sup id="cite_ref-44" class="reference"><a href="#cite_note-44"><span class="cite-bracket">[</span>44<span class="cite-bracket">]</span></a></sup> The efficiency of this treatment does not usually exceed about 20%, and late relapse after therapy has been reported.<sup id="cite_ref-45" class="reference"><a href="#cite_note-45"><span class="cite-bracket">[</span>45<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Pascarella2011_46-0" class="reference"><a href="#cite_note-Pascarella2011-46"><span class="cite-bracket">[</span>46<span class="cite-bracket">]</span></a></sup> </p><p>In May 2020, the <a href="/wiki/Committee_for_Medicinal_Products_for_Human_Use" title="Committee for Medicinal Products for Human Use">Committee for Medicinal Products for Human Use</a> of the <a href="/wiki/European_Medicines_Agency" title="European Medicines Agency">European Medicines Agency</a> approved the antiviral Hepcludex (<a href="/wiki/Bulevirtide" title="Bulevirtide">bulevirtide</a>) to treat hepatitis D.<sup id="cite_ref-European_Medicines_Agency_47-0" class="reference"><a href="#cite_note-European_Medicines_Agency-47"><span class="cite-bracket">[</span>47<span class="cite-bracket">]</span></a></sup> Bulevirtide binds and inactivates the <a href="/wiki/Sodium/bile_acid_cotransporter" title="Sodium/bile acid cotransporter">sodium/bile acid cotransporter</a>, blocking hepatitis D virus (as well as hepatitis B virus) from entering <a href="/wiki/Hepatocyte" title="Hepatocyte">hepatocytes</a>.<sup id="cite_ref-48" class="reference"><a href="#cite_note-48"><span class="cite-bracket">[</span>48<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-49" class="reference"><a href="#cite_note-49"><span class="cite-bracket">[</span>49<span class="cite-bracket">]</span></a></sup> Bulevirtide may be given with pegylated interferon alpha as the two are thought to have a synergistic effect, leading to greater treatment response rates.<sup id="cite_ref-Asselah_2023_42-3" class="reference"><a href="#cite_note-Asselah_2023-42"><span class="cite-bracket">[</span>42<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-50" class="reference"><a href="#cite_note-50"><span class="cite-bracket">[</span>50<span class="cite-bracket">]</span></a></sup> </p><p>In patients with HDV-related compensated <a href="/wiki/Cirrhosis" title="Cirrhosis">cirrhosis</a> and clinically significant portal hypertension, the treatment with (<a href="/wiki/Bulevirtide" title="Bulevirtide">bulevirtide</a>) was safe, well tolerated and has led to a significant improvement in biochemical variables and an increase in liver function parameters.<sup id="cite_ref-51" class="reference"><a href="#cite_note-51"><span class="cite-bracket">[</span>51<span class="cite-bracket">]</span></a></sup> </p><p>Other treatments for hepatitis D which are currently under development include pegylated interferon lambda (λ), which binds to receptors on the hepatocyte surface leading to an intracellular signaling cascade via the <a href="/wiki/JAK-STAT_signaling_pathway" title="JAK-STAT signaling pathway">JAK-STAT signaling pathway</a> and activation of anti-viral cell mediated immunity.<sup id="cite_ref-Sandmann_2021_52-0" class="reference"><a href="#cite_note-Sandmann_2021-52"><span class="cite-bracket">[</span>52<span class="cite-bracket">]</span></a></sup> The <a href="/wiki/Prenylation" title="Prenylation">prenylation</a> inhibitor <a href="/wiki/Lonafarnib" title="Lonafarnib">lonafarnib</a> prevents hepatitis D viral particle assembly by inhibiting the <a href="/wiki/Farnesylation" class="mw-redirect" title="Farnesylation">farnesylation</a> of the L-HDAg.<sup id="cite_ref-Koh_2015_53-0" class="reference"><a href="#cite_note-Koh_2015-53"><span class="cite-bracket">[</span>53<span class="cite-bracket">]</span></a></sup> REP2139-Ca is a nucleic acid polymer that prevents the release of hepatitis B surface antigen (which is required for assembly of hepatitis D viral particles).<sup id="cite_ref-Vaillant_2019_54-0" class="reference"><a href="#cite_note-Vaillant_2019-54"><span class="cite-bracket">[</span>54<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Prognosis">Prognosis</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hepatitis_D&action=edit&section=11" title="Edit section: Prognosis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Superinfections, in which hepatitis D viral infection occurs in someone who has chronic hepatitis B (as opposed to co-infection, in which a person is infected with hepatitis B and D simultaneously), are more likely to progress to chronic hepatitis D and are associated with a worse prognosis.<sup id="cite_ref-Asselah_2023_42-4" class="reference"><a href="#cite_note-Asselah_2023-42"><span class="cite-bracket">[</span>42<span class="cite-bracket">]</span></a></sup> 90% of cases of chronic hepatitis D infection are thought to be due to superinfection in those already with hepatitis B.<sup id="cite_ref-Asselah_2023_42-5" class="reference"><a href="#cite_note-Asselah_2023-42"><span class="cite-bracket">[</span>42<span class="cite-bracket">]</span></a></sup> Hepatitis B and D co-infection is likely to lead to acute hepatitis, but is usually self limited with regards to the hepatitis D infection.<sup id="cite_ref-Asselah_2023_42-6" class="reference"><a href="#cite_note-Asselah_2023-42"><span class="cite-bracket">[</span>42<span class="cite-bracket">]</span></a></sup> Chronic hepatitis B and D is associated with a worse prognosis than chronic hepatitis B alone.<sup id="cite_ref-Asselah_2023_42-7" class="reference"><a href="#cite_note-Asselah_2023-42"><span class="cite-bracket">[</span>42<span class="cite-bracket">]</span></a></sup> Infection with both viruses is characterized by a poor prognosis with 75% of those with chronic hepatitis D developing liver cirrhosis within 15 years and a much higher risk of developing liver cancer.<sup id="cite_ref-Asselah_2023_42-8" class="reference"><a href="#cite_note-Asselah_2023-42"><span class="cite-bracket">[</span>42<span class="cite-bracket">]</span></a></sup> Persistent HDV viremia is the most important risk factor for disease progression in those with co-infection or superinfection.<sup id="cite_ref-Asselah_2023_42-9" class="reference"><a href="#cite_note-Asselah_2023-42"><span class="cite-bracket">[</span>42<span class="cite-bracket">]</span></a></sup> Other factors that are responsible for a poor prognosis in chronic hepatitis D include male sex, older age at time of infection, alcohol use, <a href="/wiki/Diabetes" title="Diabetes">diabetes</a>, <a href="/wiki/Obesity" title="Obesity">obesity</a> and <a href="/wiki/Immunodeficiency" title="Immunodeficiency">immunodeficiency</a>.<sup id="cite_ref-Asselah_2023_42-10" class="reference"><a href="#cite_note-Asselah_2023-42"><span class="cite-bracket">[</span>42<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Epidemiology">Epidemiology</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hepatitis_D&action=edit&section=12" title="Edit section: Epidemiology"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1236090951">.mw-parser-output .hatnote{font-style:italic}.mw-parser-output div.hatnote{padding-left:1.6em;margin-bottom:0.5em}.mw-parser-output .hatnote i{font-style:normal}.mw-parser-output .hatnote+link+.hatnote{margin-top:-0.5em}@media print{body.ns-0 .mw-parser-output .hatnote{display:none!important}}</style><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Epidemiology_of_Hepatitis_D" class="mw-redirect" title="Epidemiology of Hepatitis D">Epidemiology of Hepatitis D</a></div> <figure typeof="mw:File/Thumb"><a href="/wiki/File:Hep_D_Epidemiology_Figure_1.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/5/54/Hep_D_Epidemiology_Figure_1.svg/350px-Hep_D_Epidemiology_Figure_1.svg.png" decoding="async" width="350" height="236" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/5/54/Hep_D_Epidemiology_Figure_1.svg/525px-Hep_D_Epidemiology_Figure_1.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/5/54/Hep_D_Epidemiology_Figure_1.svg/700px-Hep_D_Epidemiology_Figure_1.svg.png 2x" data-file-width="625" data-file-height="421" /></a><figcaption>Worldwide prevalence of HDV among HBV carriers in 2015. Eight genotypes have been identified worldwide by comparative phylogenetic analysis. Genotype 1 is the most frequent and has variable pathogenicity, Genotypes 2 and 4 are found in East Asia causing relatively mild disease. Genotype 3 is found in South America in association with severe hepatitis. Genotypes 5, 6, 7, 8 have been found only in Africa.<sup id="cite_ref-55" class="reference"><a href="#cite_note-55"><span class="cite-bracket">[</span>55<span class="cite-bracket">]</span></a></sup></figcaption></figure> <p>HDV is prevalent worldwide. However, the prevalence is decreasing in many higher income countries due to hepatitis B vaccination programs (although rates remain high in some groups such as those who inject drugs or immigrants from HDV endemic regions).<sup id="cite_ref-Asselah_2023_42-11" class="reference"><a href="#cite_note-Asselah_2023-42"><span class="cite-bracket">[</span>42<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-:0_56-0" class="reference"><a href="#cite_note-:0-56"><span class="cite-bracket">[</span>56<span class="cite-bracket">]</span></a></sup> Infection with HDV is a major medical scourge in low income regions of the globe in which HBV prevalence remains high.<sup id="cite_ref-:0_56-1" class="reference"><a href="#cite_note-:0-56"><span class="cite-bracket">[</span>56<span class="cite-bracket">]</span></a></sup> Currently the Amazon basin and low income regions of Asia and Africa have high rates of HDV, owing to concurrently high rates of HBV. Globally, five percent of those with chronic hepatitis B infection also have hepatitis D and 12.5% of people with HIV are also co-infected with hepatitis D.<sup id="cite_ref-WHO_57-0" class="reference"><a href="#cite_note-WHO-57"><span class="cite-bracket">[</span>57<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Asselah_2023_42-12" class="reference"><a href="#cite_note-Asselah_2023-42"><span class="cite-bracket">[</span>42<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="History">History</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hepatitis_D&action=edit&section=13" title="Edit section: History"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Hepatitis D virus was first reported in 1977 as a nuclear antigen in patients infected with HBV who had severe liver disease.<sup id="cite_ref-58" class="reference"><a href="#cite_note-58"><span class="cite-bracket">[</span>58<span class="cite-bracket">]</span></a></sup> This nuclear antigen was then thought to be a hepatitis B antigen and was called the delta antigen. Subsequent experiments in chimpanzees showed that the hepatitis delta antigen (HDAg) was a structural part of a pathogen that required HBV infection to produce a complete viral particle.<sup id="cite_ref-59" class="reference"><a href="#cite_note-59"><span class="cite-bracket">[</span>59<span class="cite-bracket">]</span></a></sup> The entire genome was cloned and sequenced in 1986. It was subsequently placed in its own genus: <i>Deltavirus</i>.<sup id="cite_ref-60" class="reference"><a href="#cite_note-60"><span class="cite-bracket">[</span>60<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-61" class="reference"><a href="#cite_note-61"><span class="cite-bracket">[</span>61<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Lábrea_fever"><span id="L.C3.A1brea_fever"></span>Lábrea fever</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hepatitis_D&action=edit&section=14" title="Edit section: Lábrea fever"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Medical condition</div><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1257001546"><table class="infobox infobox-has-images-with-white-backgrounds"><tbody><tr><th colspan="2" class="infobox-above" style="background:#ccc">Lábrea fever</th></tr><tr><th scope="row" class="infobox-label">Other names</th><td class="infobox-data">Lábrea's black fever, Lábrea hepatitis, Santa Marta fever</td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_specialty" title="Medical specialty">Specialty</a></th><td class="infobox-data"><a href="/wiki/Infectious_disease_(medical_speciality)" class="mw-redirect" title="Infectious disease (medical speciality)">Infectious disease</a></td></tr><tr><th scope="row" class="infobox-label">Usual onset</th><td class="infobox-data">sudden</td></tr><tr><th scope="row" class="infobox-label">Duration</th><td class="infobox-data">approx. 1 week</td></tr><tr><th scope="row" class="infobox-label">Prevention</th><td class="infobox-data">HBV vaccination</td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Prognosis" title="Prognosis">Prognosis</a></th><td class="infobox-data">death</td></tr></tbody></table><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236303919"> <p><b>Lábrea fever</b> is a lethal <a href="/wiki/Tropical_infections" class="mw-redirect" title="Tropical infections">tropical infection</a> discovered in the 1950s in the city of <a href="/wiki/L%C3%A1brea" title="Lábrea">Lábrea</a>, in the Brazilian <a href="/wiki/Amazon_basin" title="Amazon basin">Amazon basin</a>, where it occurs mostly in the area south of the Amazon River, in the states of <a href="/wiki/Acre_(state)" title="Acre (state)">Acre</a>, <a href="/wiki/Amazonas_State,_Brazil" class="mw-redirect" title="Amazonas State, Brazil">Amazonas</a>, and <a href="/wiki/Rond%C3%B4nia" title="Rondônia">Rondônia</a>. The disease has also been diagnosed in Colombia and Peru. It is now known to be a <a href="/wiki/Coinfection" title="Coinfection">coinfection</a> or <a href="/wiki/Superinfection" title="Superinfection">superinfection</a> of hepatitis B (HBV) with hepatitis D.<sup id="cite_ref-Bensabath_1987_62-0" class="reference"><a href="#cite_note-Bensabath_1987-62"><span class="cite-bracket">[</span>62<span class="cite-bracket">]</span></a></sup> </p><p>Lábrea fever has a sudden onset, with <a href="/wiki/Jaundice" title="Jaundice">jaundice</a>, <a href="/wiki/Anorexia_(symptom)" title="Anorexia (symptom)">anorexia</a> (lack of appetite), <a href="/wiki/Hematemesis" title="Hematemesis">hematemesis</a> (<a href="/wiki/Vomiting" title="Vomiting">vomiting</a> of blood), <a href="/wiki/Headache" title="Headache">headache</a>, <a href="/wiki/Fever" title="Fever">fever</a> and severe <a href="/wiki/Prostration_(medical)" class="mw-redirect" title="Prostration (medical)">prostration</a>. Death occurs by <a href="/wiki/Acute_liver_failure" title="Acute liver failure">acute liver failure</a> (ALF). In the last phase, <a href="/wiki/Neurology" title="Neurology">neurological symptoms</a> such as agitation, <a href="/wiki/Delirium" title="Delirium">delirium</a>, <a href="/wiki/Convulsion" title="Convulsion">convulsions</a> and hemorrhagic <a href="/wiki/Coma" title="Coma">coma</a> commonly appear. These symptoms arise from a <a href="/wiki/Fulminant" title="Fulminant">fulminant</a> <a href="/wiki/Hepatitis" title="Hepatitis">hepatitis</a> which may kill in less than a week, and which characteristically affects children and young adults, and more males than females. It is accompanied also by an <a href="/wiki/Encephalitis" title="Encephalitis">encephalitis</a> in many cases. The disease is highly lethal: in a study carried out in 1986 at <a href="/wiki/Boca_do_Acre" title="Boca do Acre">Boca do Acre</a>, also in the Amazon, 39 patients out of 44 died in the <a href="/wiki/Acute_(medical)" class="mw-redirect" title="Acute (medical)">acute</a> phase of the disease.<sup id="cite_ref-Bensabath_1987_62-1" class="reference"><a href="#cite_note-Bensabath_1987-62"><span class="cite-bracket">[</span>62<span class="cite-bracket">]</span></a></sup> Survivors may develop <a href="/wiki/Chronic_(medicine)" class="mw-redirect" title="Chronic (medicine)">chronic</a> disease.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (January 2021)">citation needed</span></a></i>]</sup> </p><p>The main discovery of delta virus and HBV association was done by <a href="/w/index.php?title=Gilberta_Bensabath&action=edit&redlink=1" class="new" title="Gilberta Bensabath (page does not exist)">Gilberta Bensabath</a>, of the <a href="/wiki/Instituto_Evandro_Chagas" class="mw-redirect" title="Instituto Evandro Chagas">Instituto Evandro Chagas</a>, of <a href="/wiki/Bel%C3%A9m" title="Belém">Belém</a>, state of <a href="/wiki/Par%C3%A1" title="Pará">Pará</a>, and her collaborators.<sup id="cite_ref-63" class="reference"><a href="#cite_note-63"><span class="cite-bracket">[</span>63<span class="cite-bracket">]</span></a></sup> </p><p>Infected patients show extensive destruction of <a href="/wiki/Liver" title="Liver">liver</a> tissue, with <a href="/wiki/Steatosis" title="Steatosis">steatosis</a> of a particular type (microsteatosis, characterized by small fat droplets inside the cells), and infiltration of large numbers of inflammatory cells called <i>morula cells</i>, comprised mainly by <a href="/wiki/Macrophage" title="Macrophage">macrophages</a> containing delta virus <a href="/wiki/Antigen" title="Antigen">antigens</a>.<sup id="cite_ref-64" class="reference"><a href="#cite_note-64"><span class="cite-bracket">[</span>64<span class="cite-bracket">]</span></a></sup> </p><p>In the 1987 Boca do Acre study, scientists did an epidemiological survey and reported delta virus infection in 24% of asymptomatic HBV carriers, 29% of acute nonfulminant hepatitis B cases, 74% of fulminant hepatitis B cases, and 100% of chronic hepatitis B cases.<sup id="cite_ref-Bensabath_1987_62-2" class="reference"><a href="#cite_note-Bensabath_1987-62"><span class="cite-bracket">[</span>62<span class="cite-bracket">]</span></a></sup> The delta virus seems to be <a href="/wiki/Endemic_(epidemiology)" title="Endemic (epidemiology)">endemic</a> in the Amazon region.<sup id="cite_ref-65" class="reference"><a href="#cite_note-65"><span class="cite-bracket">[</span>65<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Evolution">Evolution</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hepatitis_D&action=edit&section=15" title="Edit section: Evolution"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Three genotypes (I–III) were originally described. Genotype I has been isolated in Europe, North America, Africa and some Asia. Genotype II has been found in Japan, Taiwan, and <a href="/wiki/Sakha_Republic" title="Sakha Republic">Yakutia</a> (Russia). Genotype III has been found exclusively in South America (Peru, Colombia, and Venezuela). Some genomes from Taiwan and the Okinawa islands have been difficult to type but have been placed in genotype 2. However it is now known that there are at least 8 genotypes of this virus (HDV-1 to HDV-8).<sup id="cite_ref-Celik2011_66-0" class="reference"><a href="#cite_note-Celik2011-66"><span class="cite-bracket">[</span>66<span class="cite-bracket">]</span></a></sup> Phylogenetic studies suggest an African origin for this pathogen.<sup id="cite_ref-Radjef2004_35-1" class="reference"><a href="#cite_note-Radjef2004-35"><span class="cite-bracket">[</span>35<span class="cite-bracket">]</span></a></sup> </p><p>An analysis of 36 strains of genotype 3 estimated that the most recent common ancestor of these strains originated around 1930.<sup id="cite_ref-Alvarado-Mora2011_67-0" class="reference"><a href="#cite_note-Alvarado-Mora2011-67"><span class="cite-bracket">[</span>67<span class="cite-bracket">]</span></a></sup> This genotype spread exponentially from early 1950s to the 1970s in South America. The substitution rate was estimated to be 1.07<span style="margin:0 .15em 0 .25em">×</span>10<sup>−3</sup> substitutions per site per year. Another study<sup id="cite_ref-Chao1994_68-0" class="reference"><a href="#cite_note-Chao1994-68"><span class="cite-bracket">[</span>68<span class="cite-bracket">]</span></a></sup> found an overall evolution rate of 3.18<span style="margin:0 .15em 0 .25em">×</span>10<sup>−3</sup> substitutions per site per year. The mutation rate varied with position : the hypervariable region evolved faster (4.55<span style="margin:0 .15em 0 .25em">×</span>10<sup>−3</sup> substitutions per site per year) than the hepatitis delta antigen coding region (2.60<span style="margin:0 .15em 0 .25em">×</span>10<sup>−3</sup> substitutions per site per year) and the autocatalytic region (1.11<span style="margin:0 .15em 0 .25em">×</span>10<sup>−3</sup> substitutions per site per year). A third study suggested a mutation rate between 9.5<span style="margin:0 .15em 0 .25em">×</span>10<sup>−3</sup> to 1.2<span style="margin:0 .15em 0 .25em">×</span>10<sup>−3</sup> substitutions/site/year.<sup id="cite_ref-Homs2016_69-0" class="reference"><a href="#cite_note-Homs2016-69"><span class="cite-bracket">[</span>69<span class="cite-bracket">]</span></a></sup> </p><p>Genotypes, with the exception of type 1, appear to be restricted to certain geographical areas: HDV-2 (previously HDV-IIa) is found in Japan, Taiwan and Yakutia; HDV-4 (previously HDV-IIb) in Japan and Taiwan; HDV-3 in the Amazonian region; HDV-5, HDV-6, HDV-7 and HDV-8 in Africa.<sup id="cite_ref-LeGal2006_70-0" class="reference"><a href="#cite_note-LeGal2006-70"><span class="cite-bracket">[</span>70<span class="cite-bracket">]</span></a></sup> Genotype 8 has also been isolated from South America. This genotype is usually only found in Africa and may have been imported into South America during the slave trade.<sup id="cite_ref-Barros2011_71-0" class="reference"><a href="#cite_note-Barros2011-71"><span class="cite-bracket">[</span>71<span class="cite-bracket">]</span></a></sup> </p><p>HDV-specific <a href="/wiki/CD8%2B_T_cells" class="mw-redirect" title="CD8+ T cells">CD8+ T cells</a> can control the virus, but it has been found HDV mutates to escape detection by CD8+ T cells.<sup id="cite_ref-72" class="reference"><a href="#cite_note-72"><span class="cite-bracket">[</span>72<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Related_species">Related species</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hepatitis_D&action=edit&section=16" title="Edit section: Related species"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>A few other viruses with similarity to HDV have been described in species other than humans. Unlike HDV, none of them depend on a <i><a href="/wiki/Hepadnaviridae" title="Hepadnaviridae">Hepadnaviridae</a></i> (HBV family) virus to replicate. These agents have rod-like structure, a delta antigen, and a ribozyme.<sup id="cite_ref-Paraskevopoulou_etal_2020_73-0" class="reference"><a href="#cite_note-Paraskevopoulou_etal_2020-73"><span class="cite-bracket">[</span>73<span class="cite-bracket">]</span></a></sup> HDV and all such relatives are classified in their own <a href="/wiki/Realm_(virology)" title="Realm (virology)">realm</a>, <i><a href="/wiki/Ribozyviria" title="Ribozyviria">Ribozyviria</a></i>, by the <a href="/wiki/International_Committee_on_Taxonomy_of_Viruses" title="International Committee on Taxonomy of Viruses">International Committee on Taxonomy of Viruses</a>.<sup id="cite_ref-ictv_11-1" class="reference"><a href="#cite_note-ictv-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hepatitis_D&action=edit&section=17" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist reflist-columns references-column-width" style="column-width: 30em;"> <ol class="references"> <li id="cite_note-n-1"><span class="mw-cite-backlink">^ <a href="#cite_ref-n_1-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-n_1-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-n_1-2"><sup><i><b>c</b></i></sup></a></span> <span class="reference-text"><style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}</style><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.niddk.nih.gov/health-information/liver-disease/viral-hepatitis/hepatitis-d">"Hepatitis D | NIDDK"</a>. <i>National Institute of Diabetes and Digestive and Kidney Diseases</i><span class="reference-accessdate">. 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(July 2020). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7395443">"Mammalian deltavirus without hepadnavirus coinfection in the neotropical rodent <i>Proechimys semispinosus</i>"</a>. <i>Proceedings of the National Academy of Sciences of the United States of America</i>. <b>117</b> (30): <span class="nowrap">17977–</span>17983. <a href="/wiki/Bibcode_(identifier)" class="mw-redirect" title="Bibcode (identifier)">Bibcode</a>:<a rel="nofollow" class="external text" href="https://ui.adsabs.harvard.edu/abs/2020PNAS..11717977P">2020PNAS..11717977P</a>. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1073%2Fpnas.2006750117">10.1073/pnas.2006750117</a></span>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7395443">7395443</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/32651267">32651267</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Proceedings+of+the+National+Academy+of+Sciences+of+the+United+States+of+America&rft.atitle=Mammalian+deltavirus+without+hepadnavirus+coinfection+in+the+neotropical+rodent+Proechimys+semispinosus&rft.volume=117&rft.issue=30&rft.pages=%3Cspan+class%3D%22nowrap%22%3E17977-%3C%2Fspan%3E17983&rft.date=2020-07&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC7395443%23id-name%3DPMC&rft_id=info%3Apmid%2F32651267&rft_id=info%3Adoi%2F10.1073%2Fpnas.2006750117&rft_id=info%3Abibcode%2F2020PNAS..11717977P&rft.aulast=Paraskevopoulou&rft.aufirst=S&rft.au=Pirzer%2C+F&rft.au=Goldmann%2C+N&rft.au=Schmid%2C+J&rft.au=Corman%2C+VM&rft.au=Gottula%2C+LT&rft.au=Schroeder%2C+S&rft.au=Rasche%2C+A&rft.au=Muth%2C+D&rft.au=Drexler%2C+JF&rft.au=Heni%2C+AC&rft.au=Eibner%2C+GJ&rft.au=Page%2C+RA&rft.au=Jones%2C+TC&rft.au=M%C3%BCller%2C+MA&rft.au=Sommer%2C+S&rft.au=Glebe%2C+D&rft.au=Drosten%2C+C&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC7395443&rfr_id=info%3Asid%2Fen.wikipedia.org%3AHepatitis+D" class="Z3988"></span></span> </li> </ol></div> <div class="mw-heading mw-heading2"><h2 id="Bibliography">Bibliography</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hepatitis_D&action=edit&section=18" title="Edit section: Bibliography"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239549316">.mw-parser-output .refbegin{margin-bottom:0.5em}.mw-parser-output .refbegin-hanging-indents>ul{margin-left:0}.mw-parser-output .refbegin-hanging-indents>ul>li{margin-left:0;padding-left:3.2em;text-indent:-3.2em}.mw-parser-output .refbegin-hanging-indents ul,.mw-parser-output .refbegin-hanging-indents ul li{list-style:none}@media(max-width:720px){.mw-parser-output .refbegin-hanging-indents>ul>li{padding-left:1.6em;text-indent:-1.6em}}.mw-parser-output .refbegin-columns{margin-top:0.3em}.mw-parser-output .refbegin-columns ul{margin-top:0}.mw-parser-output .refbegin-columns li{page-break-inside:avoid;break-inside:avoid-column}@media screen{.mw-parser-output .refbegin{font-size:90%}}</style><div class="refbegin" style=""> <ul><li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFSpecter1999" class="citation book cs1">Specter SC, ed. (1999). <i>Viral Hepatitis: Diagnosis, Therapy, and Prevention</i>. 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href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1590%2Fs0037-86822004000700015">10.1590/s0037-86822004000700015</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/15586904">15586904</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Revista+da+Sociedade+Brasileira+de+Medicina+Tropical&rft.atitle=%5BHepatitis+fulminant+in+Brazilian+Amazon%5D&rft.volume=37&rft.issue=Suppl+2&rft.pages=%3Cspan+class%3D%22nowrap%22%3E93-%3C%2Fspan%3E5&rft.date=2004&rft_id=info%3Adoi%2F10.1590%2Fs0037-86822004000700015&rft_id=info%3Apmid%2F15586904&rft.aulast=da+Fonseca&rft.aufirst=JC&rft_id=https%3A%2F%2Fdoi.org%2F10.1590%252Fs0037-86822004000700015&rfr_id=info%3Asid%2Fen.wikipedia.org%3AHepatitis+D" class="Z3988"></span></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFBensabathSoares2004" class="citation journal cs1">Bensabath G, Soares M (2004). <a rel="nofollow" class="external text" href="https://doi.org/10.1590%2FS0037-86822004000700003">"[The evolution of knowledge about viral hepatitis in Amazon region: from epidemiology and etiology to the prophilaxy]"</a>. <i>Revista da Sociedade Brasileira de Medicina Tropical</i>. <b>37</b> (Suppl 2): <span class="nowrap">14–</span>26. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1590%2FS0037-86822004000700003">10.1590/S0037-86822004000700003</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/15586892">15586892</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Revista+da+Sociedade+Brasileira+de+Medicina+Tropical&rft.atitle=%5BThe+evolution+of+knowledge+about+viral+hepatitis+in+Amazon+region%3A+from+epidemiology+and+etiology+to+the+prophilaxy%5D&rft.volume=37&rft.issue=Suppl+2&rft.pages=%3Cspan+class%3D%22nowrap%22%3E14-%3C%2Fspan%3E26&rft.date=2004&rft_id=info%3Adoi%2F10.1590%2FS0037-86822004000700003&rft_id=info%3Apmid%2F15586892&rft.aulast=Bensabath&rft.aufirst=G&rft.au=Soares%2C+M&rft_id=https%3A%2F%2Fdoi.org%2F10.1590%252FS0037-86822004000700003&rfr_id=info%3Asid%2Fen.wikipedia.org%3AHepatitis+D" class="Z3988"></span></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFFonsecaSouzaBrasilAraújo2004" class="citation journal cs1">Fonseca JC, Souza RA, Brasil LM, Araújo JR, Ferreira LC (2004). <a rel="nofollow" class="external text" href="https://doi.org/10.1590%2FS0037-86822004000100019">"Fulminant hepatic failure in children and adolescents in Northern Brazil"</a>. <i>Revista da Sociedade Brasileira de Medicina Tropical</i>. <b>37</b> (1): <span class="nowrap">67–</span>9. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1590%2FS0037-86822004000100019">10.1590/S0037-86822004000100019</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/15042190">15042190</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Revista+da+Sociedade+Brasileira+de+Medicina+Tropical&rft.atitle=Fulminant+hepatic+failure+in+children+and+adolescents+in+Northern+Brazil&rft.volume=37&rft.issue=1&rft.pages=%3Cspan+class%3D%22nowrap%22%3E67-%3C%2Fspan%3E9&rft.date=2004&rft_id=info%3Adoi%2F10.1590%2FS0037-86822004000100019&rft_id=info%3Apmid%2F15042190&rft.aulast=Fonseca&rft.aufirst=JC&rft.au=Souza%2C+RA&rft.au=Brasil%2C+LM&rft.au=Ara%C3%BAjo%2C+JR&rft.au=Ferreira%2C+LC&rft_id=https%3A%2F%2Fdoi.org%2F10.1590%252FS0037-86822004000100019&rfr_id=info%3Asid%2Fen.wikipedia.org%3AHepatitis+D" class="Z3988"></span></li></ul> </div> <div class="mw-heading mw-heading2"><h2 id="External_links">External links</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hepatitis_D&action=edit&section=19" title="Edit section: External links"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239549316"><div class="refbegin" style=""> <ul><li><a href="/wiki/World_Health_Organization" title="World Health Organization">World Health Organization</a> <a rel="nofollow" class="external text" href="https://web.archive.org/web/20080318200937/http://www.who.int/csr/disease/hepatitis/whocdscsrncs20011/en/index.html">Fact sheet on Hepatitis D</a></li> <li><a rel="nofollow" class="external text" href="http://www.ictv.global/report/deltavirus"><b>ICTV Report: </b> <i>Deltavirus</i></a></li> <li><a rel="nofollow" class="external text" href="http://www.expasy.org/viralzone/all_by_species/175.html"><b>Viralzone</b>: Deltavirus</a></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/Taxonomy/Browser/wwwtax.cgi?mode=Info&id=12475">"<i>Hepatitis delta virus</i>"</a>. <i>NCBI Taxonomy Browser</i>. 12475.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=NCBI+Taxonomy+Browser&rft.atitle=Hepatitis+delta+virus&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2FTaxonomy%2FBrowser%2Fwwwtax.cgi%3Fmode%3DInfo%26id%3D12475&rfr_id=info%3Asid%2Fen.wikipedia.org%3AHepatitis+D" class="Z3988"></span></li></ul> </div> <div class="navbox-styles"><style data-mw-deduplicate="TemplateStyles:r1236075235">.mw-parser-output .navbox{box-sizing:border-box;border:1px solid #a2a9b1;width:100%;clear:both;font-size:88%;text-align:center;padding:1px;margin:1em auto 0}.mw-parser-output .navbox .navbox{margin-top:0}.mw-parser-output .navbox+.navbox,.mw-parser-output .navbox+.navbox-styles+.navbox{margin-top:-1px}.mw-parser-output .navbox-inner,.mw-parser-output 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Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/ICD-10" title="ICD-10">10</a></b>: <a rel="nofollow" class="external text" href="https://icd.who.int/browse10/2019/en#/B17.0">B17.0</a>, <a rel="nofollow" class="external text" href="https://icd.who.int/browse10/2019/en#/B18.0">B18.0</a></li><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/List_of_ICD-9_codes" title="List of ICD-9 codes">9-CM</a></b>: <a rel="nofollow" class="external text" href="http://www.icd9data.com/getICD9Code.ashx?icd9=070.31">070.31</a></li><li><b><a href="/wiki/Medical_Subject_Headings" title="Medical Subject Headings">MeSH</a></b>: <a rel="nofollow" class="external text" href="https://meshb.nlm.nih.gov/record/ui?ui=D003699">D003699</a></li><li><b><a href="/wiki/Diseases_Database" title="Diseases 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style="width:100%;padding:0"><div style="padding:0 0.25em"> <dl><dt><a href="/wiki/DNA_virus" title="DNA virus">DNA virus</a></dt> <dd><i><a href="/wiki/Hepatitis_B_virus" title="Hepatitis B virus">HBV</a></i> <dl><dd><a href="/wiki/Hepatocellular_carcinoma" title="Hepatocellular carcinoma">Hepatocellular carcinoma</a></dd></dl></dd> <dd><i><a href="/wiki/Papillomaviridae" title="Papillomaviridae">HPV</a></i> <dl><dd><a href="/wiki/Cervical_cancer" title="Cervical cancer">Cervical cancer</a></dd> <dd><a href="/wiki/Anal_cancer" title="Anal cancer">Anal cancer</a></dd> <dd><a href="/wiki/Penile_cancer" title="Penile cancer">Penile cancer</a></dd> <dd><a href="/wiki/Vulvar_cancer" title="Vulvar cancer">Vulvar cancer</a></dd> <dd><a href="/wiki/Vaginal_cancer" title="Vaginal cancer">Vaginal cancer</a></dd> <dd><a href="/wiki/HPV-positive_oropharyngeal_cancer" title="HPV-positive oropharyngeal cancer">Oropharyngeal cancer</a></dd></dl></dd> <dd><i><a href="/wiki/Kaposi%27s_sarcoma-associated_herpesvirus" title="Kaposi's sarcoma-associated herpesvirus">KSHV</a></i> <dl><dd><a href="/wiki/Kaposi%27s_sarcoma" title="Kaposi's sarcoma">Kaposi's sarcoma</a></dd></dl></dd> <dd><i><a href="/wiki/Epstein%E2%80%93Barr_virus" title="Epstein–Barr virus">EBV</a></i> <dl><dd><a href="/wiki/Nasopharyngeal_carcinoma" title="Nasopharyngeal carcinoma">Nasopharyngeal carcinoma</a></dd> <dd><a href="/wiki/Burkitt%27s_lymphoma" class="mw-redirect" title="Burkitt's lymphoma">Burkitt's lymphoma</a></dd> <dd><a href="/wiki/Hodgkin_lymphoma" title="Hodgkin lymphoma">Hodgkin lymphoma</a></dd> <dd><a href="/wiki/Follicular_dendritic_cell_sarcoma" title="Follicular dendritic cell sarcoma">Follicular dendritic cell sarcoma</a></dd> <dd><a href="/wiki/Extranodal_NK/T-cell_lymphoma,_nasal_type" title="Extranodal NK/T-cell lymphoma, nasal type">Extranodal NK/T-cell lymphoma, nasal type</a></dd></dl></dd> <dd><i><a href="/wiki/Merkel_cell_polyomavirus" title="Merkel cell polyomavirus">MCPyV</a></i> <dl><dd><a href="/wiki/Merkel-cell_carcinoma" title="Merkel-cell carcinoma">Merkel-cell carcinoma</a></dd></dl></dd></dl> <dl><dt><a href="/wiki/RNA_virus" title="RNA virus">RNA virus</a></dt> <dd><i><a href="/wiki/Hepatitis_C_virus" title="Hepatitis C virus">HCV</a></i> <dl><dd><a href="/wiki/Hepatocellular_carcinoma" title="Hepatocellular carcinoma">Hepatocellular carcinoma</a></dd> <dd><a href="/wiki/Splenic_marginal_zone_lymphoma" title="Splenic marginal zone lymphoma">Splenic marginal zone lymphoma</a></dd></dl></dd> <dd><i><a href="/wiki/Human_T-lymphotropic_virus_1" title="Human T-lymphotropic virus 1">HTLV-I</a></i> <dl><dd><a href="/wiki/Adult_T-cell_leukemia/lymphoma" title="Adult T-cell leukemia/lymphoma">Adult T-cell leukemia/lymphoma</a></dd></dl></dd></dl> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Immune_disorder" title="Immune disorder">Immune disorders</a></th><td 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0.25em"> <dl><dt><a href="/wiki/DNA_virus" title="DNA virus">DNA virus</a></dt> <dd><i><a href="/wiki/Human_polyomavirus_2" title="Human polyomavirus 2">Human polyomavirus 2</a></i> <dl><dd><a href="/wiki/Progressive_multifocal_leukoencephalopathy" title="Progressive multifocal leukoencephalopathy">Progressive multifocal leukoencephalopathy</a></dd></dl></dd></dl> <dl><dt><a href="/wiki/RNA_virus" title="RNA virus">RNA virus</a></dt> <dd><i><a href="/wiki/Measles_morbillivirus" class="mw-redirect" title="Measles morbillivirus">MeV</a></i> <dl><dd><a href="/wiki/Subacute_sclerosing_panencephalitis" title="Subacute sclerosing panencephalitis">Subacute sclerosing panencephalitis</a></dd></dl></dd> <dd><i><a href="/wiki/Lymphocytic_choriomeningitis" title="Lymphocytic choriomeningitis">LCV</a></i> <dl><dd><a href="/wiki/Lymphocytic_choriomeningitis" title="Lymphocytic choriomeningitis">Lymphocytic choriomeningitis</a></dd></dl></dd> <dd><a href="/wiki/Arbovirus_encephalitis" class="mw-redirect" title="Arbovirus encephalitis">Arbovirus encephalitis</a></dd> <dd><i><a href="/wiki/Orthomyxoviridae" title="Orthomyxoviridae">Orthomyxoviridae</a></i> (probable) <dl><dd><a href="/wiki/Encephalitis_lethargica" title="Encephalitis lethargica">Encephalitis lethargica</a></dd></dl></dd> <dd><i><a href="/wiki/Rabies_virus" title="Rabies virus">RV</a></i> <dl><dd><a href="/wiki/Rabies" title="Rabies">Rabies</a></dd></dl></dd> <dd><a href="/wiki/Chandipura_vesiculovirus" title="Chandipura vesiculovirus">Chandipura vesiculovirus</a></dd> <dd><a href="/wiki/Herpesviral_meningitis" class="mw-redirect" title="Herpesviral meningitis">Herpesviral meningitis</a></dd> <dd><a href="/wiki/Ramsay_Hunt_syndrome_type_2" title="Ramsay Hunt syndrome type 2">Ramsay Hunt syndrome type 2</a></dd></dl> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Myelitis" title="Myelitis">Myelitis</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Poliovirus" title="Poliovirus">Poliovirus</a></i> <ul><li><a href="/wiki/Polio" title="Polio">Poliomyelitis</a></li> <li><a href="/wiki/Post-polio_syndrome" title="Post-polio syndrome">Post-polio syndrome</a></li></ul></li> <li><i><a href="/wiki/Human_T-lymphotropic_virus_1" title="Human T-lymphotropic virus 1">HTLV-I</a></i> <ul><li><a href="/wiki/Tropical_spastic_paraparesis" title="Tropical spastic paraparesis">Tropical spastic paraparesis</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Eye_disease" title="Eye disease">Eye</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Cytomegalovirus" title="Cytomegalovirus">Cytomegalovirus</a></i> <ul><li><a href="/wiki/Cytomegalovirus_retinitis" title="Cytomegalovirus retinitis">Cytomegalovirus retinitis</a></li></ul></li> <li><i><a href="/wiki/Herpes_simplex_virus" title="Herpes simplex virus">HSV</a></i> <ul><li><a href="/wiki/Herpes_simplex_keratitis" title="Herpes simplex keratitis">Herpes of the eye</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Cardiovascular_disease" title="Cardiovascular disease">Cardiovascular</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Coxsackie_B_virus" title="Coxsackie B virus">CBV</a></i> <ul><li><a href="/wiki/Pericarditis" title="Pericarditis">Pericarditis</a></li> <li><a href="/wiki/Myocarditis" title="Myocarditis">Myocarditis</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Respiratory_system" title="Respiratory system">Respiratory system</a>/<br /><a href="/wiki/Common_cold" title="Common cold">acute viral<br />nasopharyngitis</a>/<br /><a href="/wiki/Viral_pneumonia" title="Viral pneumonia">viral pneumonia</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/DNA_virus" title="DNA virus">DNA virus</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Epstein%E2%80%93Barr_virus" title="Epstein–Barr virus">Epstein–Barr virus</a></i> <ul><li><a href="/wiki/Epstein%E2%80%93Barr_virus_infection" title="Epstein–Barr virus infection">EBV infection</a>/<a href="/wiki/Infectious_mononucleosis" title="Infectious mononucleosis">Infectious mononucleosis</a></li></ul></li> <li><i><a href="/wiki/Cytomegalovirus" title="Cytomegalovirus">Cytomegalovirus</a></i></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/RNA_virus" title="RNA virus">RNA virus</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/RNA_virus#Group_IV_–_positive-sense_ssRNA_viruses" title="RNA virus">IV</a>: <i><a href="/wiki/Human_coronavirus" class="mw-redirect" title="Human coronavirus">Human coronavirus</a> <a href="/wiki/Human_coronavirus_229E" title="Human coronavirus 229E">229E</a>/<a href="/wiki/Human_coronavirus_NL63" title="Human coronavirus NL63">NL63</a>/<a href="/wiki/Human_coronavirus_HKU1" title="Human coronavirus HKU1">HKU1</a>/<a href="/wiki/Human_coronavirus_OC43" title="Human coronavirus OC43">OC43</a></i> <ul><li><a href="/wiki/Common_cold" title="Common cold">Common cold</a></li></ul></li> <li><i><a href="/wiki/Middle_East_respiratory_syndrome%E2%80%93related_coronavirus" class="mw-redirect" title="Middle East respiratory syndrome–related coronavirus">MERS coronavirus</a></i> <ul><li><a href="/wiki/Middle_East_respiratory_syndrome" class="mw-redirect" title="Middle East respiratory syndrome">Middle East respiratory syndrome</a></li></ul></li> <li><i><a href="/wiki/Severe_acute_respiratory_syndrome_coronavirus" class="mw-redirect" title="Severe acute respiratory syndrome coronavirus">SARS coronavirus</a></i> <ul><li><a href="/wiki/Severe_acute_respiratory_syndrome" class="mw-redirect" title="Severe acute respiratory syndrome">Severe acute respiratory syndrome</a></li></ul></li> <li><i><a href="/wiki/SARS-CoV-2" title="SARS-CoV-2">SARS-CoV-2</a></i> <ul><li><a href="/wiki/COVID-19" title="COVID-19">COVID-19</a></li></ul></li></ul> <ul><li><a href="/wiki/RNA_virus#Group_V_–_negative-sense_ssRNA_viruses" title="RNA virus">V</a>, <i><a href="/wiki/Orthomyxoviridae" title="Orthomyxoviridae">Orthomyxoviridae</a></i>: <i><a href="/wiki/Influenza_A_virus" title="Influenza A virus">Influenza virus A</a>/<a href="/wiki/Influenza_B_virus" title="Influenza B virus">B</a>/<a href="/wiki/Influenza_C_virus" title="Influenza C virus">C</a>/<a href="/wiki/Influenza_D_virus" title="Influenza D virus">D</a></i> <ul><li><a href="/wiki/Influenza" title="Influenza">Influenza</a>/<a href="/wiki/Avian_influenza" title="Avian influenza">Avian influenza</a></li></ul></li></ul> <ul><li>V, <i><a href="/wiki/Paramyxoviridae" title="Paramyxoviridae">Paramyxoviridae</a></i>: <i><a href="/wiki/Human_parainfluenza_viruses" title="Human parainfluenza viruses">Human parainfluenza viruses</a></i> <ul><li><a href="/wiki/Human_parainfluenza_viruses" title="Human parainfluenza viruses">Parainfluenza</a></li></ul></li> <li><i><a href="/wiki/Human_orthopneumovirus" class="mw-redirect" title="Human orthopneumovirus">Human orthopneumovirus</a></i></li> <li><i><a href="/wiki/Human_metapneumovirus" title="Human metapneumovirus">hMPV</a></i></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Human_digestive_system" title="Human digestive system">Human<br /> digestive system</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Pharynx" title="Pharynx">Pharynx</a>/<a href="/wiki/Esophagus" title="Esophagus">Esophagus</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Mumps_virus" title="Mumps virus">MuV</a></i> <ul><li><a href="/wiki/Mumps" title="Mumps">Mumps</a></li></ul></li> <li><i><a href="/wiki/Cytomegalovirus" title="Cytomegalovirus">Cytomegalovirus</a></i> <ul><li><a href="/wiki/Cytomegalovirus_esophagitis" title="Cytomegalovirus esophagitis">Cytomegalovirus esophagitis</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Gastroenteritis#Viral" title="Gastroenteritis">Gastroenteritis</a>/<br /><a href="/wiki/Gastroenteritis#Virus" title="Gastroenteritis">diarrhea</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <dl><dt><a href="/wiki/DNA_virus" title="DNA virus">DNA virus</a></dt> <dd><i><a href="/wiki/Adenoviridae" title="Adenoviridae">Adenovirus</a></i> <dl><dd><a href="/wiki/Adenovirus_infection" title="Adenovirus infection">Adenovirus infection</a></dd></dl></dd></dl> <dl><dt><a href="/wiki/RNA_virus" title="RNA virus">RNA virus</a></dt> <dd><i><a href="/wiki/Rotavirus" title="Rotavirus">Rotavirus</a></i> (<a href="/wiki/Rotaviral_gastroenteritis" class="mw-redirect" title="Rotaviral gastroenteritis">Gastroenteritis</a>)</dd> <dd><i><a href="/wiki/Norovirus" title="Norovirus">Norovirus</a></i></dd> <dd><i><a href="/wiki/Astrovirus" title="Astrovirus">Astrovirus</a></i></dd> <dd><i><a href="/wiki/Coronavirus" title="Coronavirus">Coronavirus</a></i></dd></dl> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Viral_hepatitis" title="Viral hepatitis">Hepatitis</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <dl><dt><a href="/wiki/DNA_virus" title="DNA virus">DNA virus</a></dt> <dd><i><a href="/wiki/Hepatitis_B_virus" title="Hepatitis B virus">HBV</a></i> (<a href="/wiki/Hepatitis_B" title="Hepatitis B">B</a>)</dd></dl> <dl><dt><a href="/wiki/RNA_virus" title="RNA virus">RNA virus</a></dt> <dd><i><a href="/wiki/Coxsackie_B_virus" title="Coxsackie B virus">CBV</a></i></dd> <dd><i><a href="/wiki/Hepatitis_A#Virology" title="Hepatitis A">HAV</a></i> (<a href="/wiki/Hepatitis_A" title="Hepatitis A">A</a>)</dd> <dd><i><a href="/wiki/Hepatitis_C_virus" title="Hepatitis C virus">HCV</a></i> (<a href="/wiki/Hepatitis_C" title="Hepatitis C">C</a>)</dd> <dd><i><a class="mw-selflink selflink">HDV</a></i> (<a class="mw-selflink selflink">D</a>)</dd> <dd><i><a href="/wiki/Orthohepevirus_A" title="Orthohepevirus A">HEV</a></i> (<a href="/wiki/Hepatitis_E" title="Hepatitis E">E</a>)</dd></dl> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Pancreatitis" title="Pancreatitis">Pancreatitis</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Coxsackie_B_virus" title="Coxsackie B virus">CBV</a></i></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Genitourinary_system" title="Genitourinary system">Urogenital</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/BK_virus" title="BK virus">BK virus</a></i></li> <li><i><a href="/wiki/Mumps_virus" title="Mumps virus">MuV</a></i> <ul><li><a href="/wiki/Mumps" title="Mumps">Mumps</a></li></ul></li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Diseases_of_the_human_digestive_system290" style="padding:3px"><table class="nowraplinks mw-collapsible mw-collapsed navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231"><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Digestive_system_diseases" title="Template:Digestive system diseases"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Digestive_system_diseases" title="Template talk:Digestive system diseases"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Digestive_system_diseases" title="Special:EditPage/Template:Digestive system diseases"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Diseases_of_the_human_digestive_system290" style="font-size:114%;margin:0 4em">Diseases of the <a href="/wiki/Human_digestive_system" title="Human digestive system">human digestive system</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Gastrointestinal_tract#Upper_gastrointestinal_tract" title="Gastrointestinal tract">Upper GI tract</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Esophageal_disease" title="Esophageal disease">Esophagus</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Esophagitis" title="Esophagitis">Esophagitis</a> <ul><li><a href="/wiki/Esophageal_candidiasis" title="Esophageal candidiasis">Candidal</a></li> <li><a href="/wiki/Eosinophilic_esophagitis" title="Eosinophilic esophagitis">Eosinophilic</a></li> <li><a href="/wiki/Herpetiform_esophagitis" class="mw-redirect" title="Herpetiform esophagitis">Herpetiform</a></li></ul></li> <li><i>Rupture</i> <ul><li><a href="/wiki/Boerhaave_syndrome" class="mw-redirect" title="Boerhaave syndrome">Boerhaave syndrome</a></li> <li><a href="/wiki/Mallory%E2%80%93Weiss_syndrome" title="Mallory–Weiss syndrome">Mallory–Weiss syndrome</a></li></ul></li> <li><a href="/wiki/Zenker%27s_diverticulum" title="Zenker's diverticulum">Zenker's diverticulum</a></li> <li><a href="/wiki/Barrett%27s_esophagus" title="Barrett's esophagus">Barrett's esophagus</a></li> <li><a href="/wiki/Esophageal_motility_disorder" title="Esophageal motility disorder">Esophageal motility disorder</a> <ul><li><a href="/wiki/Nutcracker_esophagus" title="Nutcracker esophagus">Nutcracker esophagus</a></li> <li><a href="/wiki/Achalasia" class="mw-redirect" title="Achalasia">Achalasia</a></li> <li><a href="/wiki/Esophagogastric_junction_outflow_obstruction" title="Esophagogastric junction outflow obstruction">Esophagogastric junction outflow obstruction</a></li> <li><a href="/wiki/Diffuse_esophageal_spasm" title="Diffuse esophageal spasm">Diffuse esophageal spasm</a></li> <li><a href="/wiki/Gastroesophageal_reflux_disease" title="Gastroesophageal reflux disease">Gastroesophageal reflux disease</a> (GERD)</li></ul></li> <li><a href="/wiki/Laryngopharyngeal_reflux" title="Laryngopharyngeal reflux">Laryngopharyngeal reflux</a> (LPR)</li> <li><a href="/wiki/Esophageal_stricture" title="Esophageal stricture">Esophageal stricture</a></li> <li><a href="/wiki/Esophageal_inlet_patch" title="Esophageal inlet patch">Inlet patch</a></li> <li><a href="/wiki/Megaesophagus" title="Megaesophagus">Megaesophagus</a></li> <li><a href="/wiki/Esophageal_intramural_pseudodiverticulosis" title="Esophageal intramural pseudodiverticulosis">Esophageal intramural pseudodiverticulosis</a></li> <li><a href="/wiki/Acute_esophageal_necrosis" title="Acute esophageal necrosis">Acute esophageal necrosis</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Stomach_disease" title="Stomach disease">Stomach</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Gastritis" title="Gastritis">Gastritis</a> <ul><li><a href="/wiki/Atrophic_gastritis" title="Atrophic gastritis">Atrophic</a></li> <li><a href="/wiki/M%C3%A9n%C3%A9trier%27s_disease" title="Ménétrier's disease">Ménétrier's disease</a></li> <li><a href="/wiki/Gastroenteritis" title="Gastroenteritis">Gastroenteritis</a></li></ul></li> <li><a href="/wiki/Peptic_ulcer" class="mw-redirect" title="Peptic ulcer">Peptic (gastric) ulcer</a> <ul><li><a href="/wiki/Cushing_ulcer" title="Cushing ulcer">Cushing ulcer</a></li> <li><a href="/wiki/Dieulafoy%27s_lesion" title="Dieulafoy's lesion">Dieulafoy's lesion</a></li></ul></li> <li><a href="/wiki/Dyspepsia" class="mw-redirect" title="Dyspepsia">Dyspepsia</a> <ul><li><a href="/wiki/Functional_dyspepsia" title="Functional dyspepsia">Functional dyspepsia</a></li></ul></li> <li><a href="/wiki/Pyloric_stenosis" title="Pyloric stenosis">Pyloric stenosis</a></li> <li><a href="/wiki/Achlorhydria" title="Achlorhydria">Achlorhydria</a></li> <li><a href="/wiki/Gastroparesis" title="Gastroparesis">Gastroparesis</a></li> <li><a href="/wiki/Gastroptosis" title="Gastroptosis">Gastroptosis</a></li> <li><a href="/wiki/Portal_hypertensive_gastropathy" title="Portal hypertensive gastropathy">Portal hypertensive gastropathy</a></li> <li><a href="/wiki/Gastric_antral_vascular_ectasia" title="Gastric antral vascular ectasia">Gastric antral vascular ectasia</a></li> <li><a href="/wiki/Gastric_dumping_syndrome" class="mw-redirect" title="Gastric dumping syndrome">Gastric dumping syndrome</a></li> <li><a href="/wiki/Gastric_volvulus" title="Gastric volvulus">Gastric volvulus</a></li> <li><a href="/wiki/Buried_bumper_syndrome" title="Buried bumper syndrome">Buried bumper syndrome</a></li> <li><a href="/wiki/Gastrinoma" title="Gastrinoma">Gastrinoma</a> <ul><li><a href="/wiki/Zollinger%E2%80%93Ellison_syndrome" title="Zollinger–Ellison syndrome">Zollinger–Ellison syndrome</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Gastrointestinal_tract#Lower_gastrointestinal_tract" title="Gastrointestinal tract">Lower GI tract</a> <br /> <a href="/wiki/Enteropathy" title="Enteropathy">Enteropathy</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Small_intestine" title="Small intestine">Small intestine</a> <br /> (<a href="/wiki/Duodenum" title="Duodenum">Duodenum</a>/<a href="/wiki/Jejunum" title="Jejunum">Jejunum</a>/<a href="/wiki/Ileum" title="Ileum">Ileum</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Enteritis" title="Enteritis">Enteritis</a> <ul><li><a href="/wiki/Duodenitis" title="Duodenitis">Duodenitis</a></li> <li><a href="/wiki/Jejunitis" title="Jejunitis">Jejunitis</a></li> <li><a href="/wiki/Ileitis" title="Ileitis">Ileitis</a></li></ul></li> <li><a href="/wiki/Peptic_ulcer" class="mw-redirect" title="Peptic ulcer">Peptic (duodenal) ulcer</a> <ul><li><a href="/wiki/Curling%27s_ulcer" title="Curling's ulcer">Curling's ulcer</a></li></ul></li> <li><a href="/wiki/Malabsorption" title="Malabsorption">Malabsorption</a>: <a href="/wiki/Coeliac_disease" title="Coeliac disease">Coeliac</a></li> <li><a href="/wiki/Tropical_sprue" title="Tropical sprue">Tropical sprue</a></li> <li><a href="/wiki/Blind_loop_syndrome" title="Blind loop syndrome">Blind loop syndrome</a></li> <li><a href="/wiki/Small_intestinal_bacterial_overgrowth" title="Small intestinal bacterial overgrowth">Small intestinal bacterial overgrowth</a></li> <li><a href="/wiki/Whipple%27s_disease" title="Whipple's disease">Whipple's</a></li> <li><a href="/wiki/Short_bowel_syndrome" title="Short bowel syndrome">Short bowel syndrome</a></li> <li><a href="/wiki/Steatorrhea" title="Steatorrhea">Steatorrhea</a></li> <li><a href="/wiki/Milroy_disease" class="mw-redirect" title="Milroy disease">Milroy disease</a></li> <li><a href="/wiki/Bile_acid_malabsorption" title="Bile acid malabsorption">Bile acid malabsorption</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Large_intestine" title="Large intestine">Large intestine</a> <br /> (<a href="/wiki/Vermiform_appendix" class="mw-redirect" title="Vermiform appendix">Appendix</a>/<a href="/wiki/Colon_(anatomy)" class="mw-redirect" title="Colon (anatomy)">Colon</a>)</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Appendicitis" title="Appendicitis">Appendicitis</a></li> <li><a href="/wiki/Colitis" title="Colitis">Colitis</a> <ul><li><a href="/wiki/Pseudomembranous_colitis" class="mw-redirect" title="Pseudomembranous colitis">Pseudomembranous</a></li> <li><a href="/wiki/Ulcerative_colitis" title="Ulcerative colitis">Ulcerative</a></li> <li><a href="/wiki/Ischemic_colitis" title="Ischemic colitis">Ischemic</a></li> <li><a href="/wiki/Microscopic_colitis" title="Microscopic colitis">Microscopic</a></li> <li><a href="/wiki/Collagenous_colitis" title="Collagenous colitis">Collagenous</a></li> <li><a href="/wiki/Lymphocytic_colitis" title="Lymphocytic colitis">Lymphocytic</a></li></ul></li> <li><a href="/wiki/Dysentery" title="Dysentery">Dysentery</a></li> <li><a href="/wiki/Functional_colonic_disease" class="mw-redirect" title="Functional colonic disease">Functional colonic disease</a> <ul><li><a href="/wiki/Irritable_bowel_syndrome" title="Irritable bowel syndrome">IBS</a></li> <li><a href="/wiki/Intestinal_pseudoobstruction" class="mw-redirect" title="Intestinal pseudoobstruction">Intestinal pseudoobstruction</a> / <a href="/wiki/Ogilvie_syndrome" title="Ogilvie syndrome">Ogilvie syndrome</a></li></ul></li> <li><a href="/wiki/Megacolon" title="Megacolon">Megacolon</a> / <a href="/wiki/Toxic_megacolon" title="Toxic megacolon">Toxic megacolon</a></li> <li><a href="/wiki/Diverticulitis" title="Diverticulitis">Diverticulitis</a>/<a href="/wiki/Diverticulosis" title="Diverticulosis">Diverticulosis</a>/<a href="/wiki/Segmental_colitis_associated_with_diverticulosis" title="Segmental colitis associated with diverticulosis">SCAD</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Large and/or small</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Enterocolitis" title="Enterocolitis">Enterocolitis</a> <ul><li><a href="/wiki/Necrotizing_enterocolitis" title="Necrotizing enterocolitis">Necrotizing</a></li></ul></li> <li><a href="/wiki/Gastroenterocolitis" title="Gastroenterocolitis">Gastroenterocolitis</a></li> <li><a href="/wiki/Inflammatory_bowel_disease" title="Inflammatory bowel disease">IBD</a> <ul><li><a href="/wiki/Crohn%27s_disease" title="Crohn's disease">Crohn's disease</a></li></ul></li> <li><i><a href="/wiki/Vascular_disease" title="Vascular disease">Vascular</a></i>: <a href="/wiki/Abdominal_angina" title="Abdominal angina">Abdominal angina</a></li> <li><a href="/wiki/Mesenteric_ischemia" class="mw-redirect" title="Mesenteric ischemia">Mesenteric ischemia</a></li> <li><a href="/wiki/Angiodysplasia" title="Angiodysplasia">Angiodysplasia</a></li> <li><a href="/wiki/Bowel_obstruction" title="Bowel obstruction">Bowel obstruction</a>: <a href="/wiki/Ileus" title="Ileus">Ileus</a></li> <li><a href="/wiki/Intussusception_(medical_disorder)" title="Intussusception (medical disorder)">Intussusception</a></li> <li><a href="/wiki/Volvulus" title="Volvulus">Volvulus</a></li> <li><a href="/wiki/Fecal_impaction" title="Fecal impaction">Fecal impaction</a></li> <li><a href="/wiki/Constipation" title="Constipation">Constipation</a> <ul><li><a href="/wiki/Functional_constipation" title="Functional constipation">Functional</a></li></ul></li> <li><a href="/wiki/Diarrhea" title="Diarrhea">Diarrhea</a> <ul><li><a href="/wiki/Infectious_diarrhea" class="mw-redirect" title="Infectious diarrhea">Infectious</a></li></ul></li> <li><a href="/wiki/Adhesion_(medicine)" title="Adhesion (medicine)">Intestinal adhesions</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Rectum" title="Rectum">Rectum</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Proctitis" title="Proctitis">Proctitis</a> <ul><li><a href="/wiki/Radiation_proctitis" title="Radiation proctitis">Radiation proctitis</a></li></ul></li> <li><a href="/wiki/Proctalgia_fugax" title="Proctalgia fugax">Proctalgia fugax</a></li> <li><a href="/wiki/Rectal_prolapse" title="Rectal prolapse">Rectal prolapse</a> (<a href="/wiki/Internal_rectal_prolapse" title="Internal rectal prolapse">Internal rectal prolapse</a>)</li> <li><a href="/wiki/Anismus" title="Anismus">Anismus</a></li> <li><a href="/wiki/Solitary_rectal_ulcer_syndrome" title="Solitary rectal ulcer syndrome">Solitary rectal ulcer syndrome</a></li> <li><a href="/wiki/Rectal_stricture" title="Rectal stricture">Rectal stricture</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Anal_canal" title="Anal canal">Anal canal</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Anal_fissure" title="Anal fissure">Anal fissure</a>/<a href="/wiki/Anal_fistula" title="Anal fistula">Anal fistula</a></li> <li><a href="/wiki/Anal_abscess" class="mw-redirect" title="Anal abscess">Anal abscess</a></li> <li><a href="/wiki/Hemorrhoid" title="Hemorrhoid">Hemorrhoid</a></li> <li><a href="/wiki/Anal_dysplasia" title="Anal dysplasia">Anal dysplasia</a></li> <li><a href="/wiki/Pruritus_ani" title="Pruritus ani">Pruritus ani</a></li> <li><a href="/wiki/Anal_stricture" title="Anal stricture">Anal stricture</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Gastrointestinal_bleeding" title="Gastrointestinal bleeding">GI bleeding</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Blood_in_stool" title="Blood in stool">Blood in stool</a></li> <li><a href="/wiki/Upper_gastrointestinal_bleeding" title="Upper gastrointestinal bleeding">Upper</a> <ul><li><a href="/wiki/Hematemesis" title="Hematemesis">Hematemesis</a></li> <li><a href="/wiki/Melena" title="Melena">Melena</a></li></ul></li> <li><a href="/wiki/Lower_gastrointestinal_bleeding" title="Lower gastrointestinal bleeding">Lower</a> <ul><li><a href="/wiki/Hematochezia" title="Hematochezia">Hematochezia</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Accessory_digestive_gland" class="mw-redirect" title="Accessory digestive gland">Accessory</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Liver_disease" title="Liver disease">Liver</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Hepatitis" title="Hepatitis">Hepatitis</a> <ul><li><a href="/wiki/Viral_hepatitis" title="Viral hepatitis">Viral hepatitis</a></li> <li><a href="/wiki/Autoimmune_hepatitis" title="Autoimmune hepatitis">Autoimmune hepatitis</a></li> <li><a href="/wiki/Alcoholic_hepatitis" title="Alcoholic hepatitis">Alcoholic hepatitis</a></li></ul></li> <li><a href="/wiki/Cirrhosis" title="Cirrhosis">Cirrhosis</a> <ul><li><a href="/wiki/Primary_biliary_cirrhosis" class="mw-redirect" title="Primary biliary cirrhosis">PBC</a></li></ul></li> <li><a href="/wiki/Fatty_liver" class="mw-redirect" title="Fatty liver">Fatty liver</a> <ul><li><a href="/wiki/Metabolic_dysfunction%E2%80%93associated_steatotic_liver_disease" title="Metabolic dysfunction–associated steatotic liver disease">MASLD</a></li></ul></li> <li><i><a href="/wiki/Vascular_disease" title="Vascular disease">Vascular</a></i> <ul><li><a href="/wiki/Budd%E2%80%93Chiari_syndrome" title="Budd–Chiari syndrome">Budd–Chiari syndrome</a></li> <li><a href="/wiki/Hepatic_veno-occlusive_disease" title="Hepatic veno-occlusive disease">Hepatic veno-occlusive disease</a></li> <li><a href="/wiki/Portal_hypertension" title="Portal hypertension">Portal hypertension</a></li> <li><a href="/wiki/Nutmeg_liver" class="mw-redirect" title="Nutmeg liver">Nutmeg liver</a></li></ul></li> <li><a href="/wiki/Alcoholic_liver_disease" title="Alcoholic liver disease">Alcoholic liver disease</a></li> <li><a href="/wiki/Liver_failure" title="Liver failure">Liver failure</a> <ul><li><a href="/wiki/Hepatic_encephalopathy" title="Hepatic encephalopathy">Hepatic encephalopathy</a></li> <li><a href="/wiki/Acute_liver_failure" title="Acute liver failure">Acute liver failure</a></li></ul></li> <li><a href="/wiki/Liver_abscess" title="Liver abscess">Liver abscess</a> <ul><li><a href="/wiki/Pyogenic_liver_abscess" title="Pyogenic liver abscess">Pyogenic</a></li> <li><a href="/wiki/Amoebic_liver_abscess" title="Amoebic liver abscess">Amoebic</a></li></ul></li> <li><a href="/wiki/Hepatorenal_syndrome" title="Hepatorenal syndrome">Hepatorenal syndrome</a></li> <li><a href="/wiki/Peliosis_hepatis" title="Peliosis hepatis">Peliosis hepatis</a></li> <li><a href="/wiki/Metabolic_disorder" title="Metabolic disorder">Metabolic disorders</a> <ul><li><a href="/wiki/Wilson%27s_disease" title="Wilson's disease">Wilson's disease</a></li> <li><a href="/wiki/Hemochromatosis" class="mw-redirect" title="Hemochromatosis">Hemochromatosis</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Gallbladder_disease" title="Gallbladder disease">Gallbladder</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Cholecystitis" title="Cholecystitis">Cholecystitis</a></li> <li><a href="/wiki/Gallstone" title="Gallstone">Gallstone / Cholelithiasis</a></li> <li><a href="/wiki/Cholesterolosis_of_gallbladder" title="Cholesterolosis of gallbladder">Cholesterolosis</a></li> <li><a href="/wiki/Adenomyomatosis" title="Adenomyomatosis">Adenomyomatosis</a></li> <li><a href="/wiki/Postcholecystectomy_syndrome" title="Postcholecystectomy syndrome">Postcholecystectomy syndrome</a></li> <li><a href="/wiki/Porcelain_gallbladder" title="Porcelain gallbladder">Porcelain gallbladder</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Bile_duct" title="Bile duct">Bile duct</a>/ <br /> Other <a href="/wiki/Biliary_tree" class="mw-redirect" title="Biliary tree">biliary tree</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Cholangitis" class="mw-redirect" title="Cholangitis">Cholangitis</a> <ul><li><a href="/wiki/Primary_sclerosing_cholangitis" title="Primary sclerosing cholangitis">Primary sclerosing cholangitis</a></li> <li><a href="/wiki/Secondary_sclerosing_cholangitis" title="Secondary sclerosing cholangitis">Secondary sclerosing cholangitis</a></li> <li><a href="/wiki/Ascending_cholangitis" title="Ascending cholangitis">Ascending</a></li></ul></li> <li><a href="/wiki/Cholestasis" title="Cholestasis">Cholestasis</a>/<a href="/wiki/Mirizzi%27s_syndrome" title="Mirizzi's syndrome">Mirizzi's syndrome</a></li> <li><a href="/wiki/Biliary_fistula" title="Biliary fistula">Biliary fistula</a></li> <li><a href="/wiki/Haemobilia" title="Haemobilia">Haemobilia</a></li></ul> <ul><li><i><a href="/wiki/Common_bile_duct" title="Common bile duct">Common bile duct</a></i> <ul><li><a href="/wiki/Choledocholithiasis" class="mw-redirect" title="Choledocholithiasis">Choledocholithiasis</a></li> <li><a href="/wiki/Biliary_dyskinesia" title="Biliary dyskinesia">Biliary dyskinesia</a></li></ul></li> <li><a href="/wiki/Sphincter_of_Oddi_dysfunction" title="Sphincter of Oddi dysfunction">Sphincter of Oddi dysfunction</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Pancreatic_disease" title="Pancreatic disease">Pancreatic</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Pancreatitis" title="Pancreatitis">Pancreatitis</a> <ul><li><a href="/wiki/Acute_pancreatitis" title="Acute pancreatitis">Acute</a></li> <li><a href="/wiki/Chronic_pancreatitis" title="Chronic pancreatitis">Chronic</a></li> <li><a href="/wiki/Hereditary_pancreatitis" title="Hereditary pancreatitis">Hereditary</a></li> <li><a href="/wiki/Pancreatic_abscess" title="Pancreatic abscess">Pancreatic abscess</a></li></ul></li> <li><a href="/wiki/Pancreatic_pseudocyst" title="Pancreatic pseudocyst">Pancreatic pseudocyst</a></li> <li><a href="/wiki/Exocrine_pancreatic_insufficiency" title="Exocrine pancreatic insufficiency">Exocrine pancreatic insufficiency</a></li> <li><a href="/wiki/Pancreatic_fistula" title="Pancreatic fistula">Pancreatic fistula</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th id="Hernia43" scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Hernia" title="Hernia">Hernia</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Diaphragmatic_hernia" title="Diaphragmatic hernia">Diaphragmatic</a> <ul><li><a href="/wiki/Congenital_diaphragmatic_hernia" title="Congenital diaphragmatic hernia">Congenital</a></li></ul></li> <li><a href="/wiki/Hiatus_hernia" class="mw-redirect" title="Hiatus hernia">Hiatus</a></li></ul> <ul><li><a href="/wiki/Inguinal_hernia" title="Inguinal hernia">Inguinal</a> <ul><li><a href="/wiki/Indirect_inguinal_hernia" class="mw-redirect" title="Indirect inguinal hernia">Indirect</a></li> <li><a href="/wiki/Direct_inguinal_hernia" class="mw-redirect" title="Direct inguinal hernia">Direct</a></li></ul></li> <li><a href="/wiki/Umbilical_hernia" title="Umbilical hernia">Umbilical</a></li> <li><a href="/wiki/Femoral_hernia" title="Femoral hernia">Femoral</a></li> <li><a href="/wiki/Obturator_hernia" title="Obturator hernia">Obturator</a></li> <li><a href="/wiki/Spigelian_hernia" title="Spigelian hernia">Spigelian</a></li></ul> <ul><li><i><a href="/wiki/Lumbar_hernia" class="mw-redirect" title="Lumbar hernia">Lumbar</a></i> <ul><li><a href="/wiki/Petit%27s_hernia" title="Petit's hernia">Petit's</a></li> <li><a href="/wiki/Grynfeltt%E2%80%93Lesshaft_hernia" title="Grynfeltt–Lesshaft hernia">Grynfeltt–Lesshaft</a></li></ul></li></ul> <ul><li><i>Undefined location</i> <ul><li><a href="/wiki/Incisional_hernia" title="Incisional hernia">Incisional</a></li> <li><a href="/wiki/Internal_hernia" title="Internal hernia">Internal hernia</a></li> <li><a href="/wiki/Richter%27s_hernia" title="Richter's hernia">Richter's</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Peritoneal_disease" class="mw-redirect" title="Peritoneal disease">Peritoneal</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Peritonitis" title="Peritonitis">Peritonitis</a> <ul><li><a href="/wiki/Spontaneous_bacterial_peritonitis" title="Spontaneous bacterial peritonitis">Spontaneous bacterial peritonitis</a></li></ul></li> <li><a href="/wiki/Hemoperitoneum" title="Hemoperitoneum">Hemoperitoneum</a></li> <li><a href="/wiki/Pneumoperitoneum" title="Pneumoperitoneum">Pneumoperitoneum</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Taxon_identifiers2600" style="padding:3px"><table class="nowraplinks hlist navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><div id="Taxon_identifiers2600" style="font-size:114%;margin:0 4em"><a href="/wiki/Help:Taxon_identifiers" title="Help:Taxon identifiers">Taxon identifiers</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align: left;"><i>Hepatitis delta virus</i></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><span style="white-space:nowrap;"><a href="/wiki/Wikidata" title="Wikidata">Wikidata</a>: <span class="uid"><span class="external"><a href="https://www.wikidata.org/wiki/Q1607636" class="extiw" title="wikidata:Q1607636">Q1607636</a></span></span></span></li> <li><span style="white-space:nowrap;"><a href="/wiki/Wikispecies" title="Wikispecies">Wikispecies</a>: <span class="uid"><span class="external"><a href="https://species.wikimedia.org/wiki/Hepatitis_delta_virus" class="extiw" title="wikispecies:Hepatitis delta virus">Hepatitis delta virus</a></span></span></span></li> <li><span style="white-space:nowrap;"><a href="/wiki/Encyclopedia_of_Life" title="Encyclopedia of Life">EoL</a>: <span class="uid"><a rel="nofollow" class="external text" href="https://eol.org/pages/539833">539833</a></span></span></li> <li><span style="white-space:nowrap;"><a href="/wiki/Global_Biodiversity_Information_Facility" title="Global Biodiversity Information Facility">GBIF</a>: <span class="uid"><a rel="nofollow" class="external text" href="https://www.gbif.org/species/10071458">10071458</a></span></span></li> <li><span style="white-space:nowrap;"><a href="/wiki/Interim_Register_of_Marine_and_Nonmarine_Genera" title="Interim Register of Marine and Nonmarine Genera">IRMNG</a>: <span class="uid"><a rel="nofollow" class="external text" href="https://www.irmng.org/aphia.php?p=taxdetails&id=11459946">11459946</a></span></span></li> <li><span style="white-space:nowrap;"><a href="/wiki/National_Center_for_Biotechnology_Information" title="National Center for Biotechnology Information">NCBI</a>: <span class="uid"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/Taxonomy/Browser/wwwtax.cgi?mode=Info&id=12475">12475</a></span></span></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align: left;"><i>Deltavirus</i></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><span style="white-space:nowrap;"><a href="/wiki/Wikidata" title="Wikidata">Wikidata</a>: <span class="uid"><span class="external"><a href="https://www.wikidata.org/wiki/Q18822400" class="extiw" title="wikidata:Q18822400">Q18822400</a></span></span></span></li> <li><span style="white-space:nowrap;"><a href="/wiki/Wikispecies" title="Wikispecies">Wikispecies</a>: <span class="uid"><span class="external"><a href="https://species.wikimedia.org/wiki/Deltavirus" class="extiw" title="wikispecies:Deltavirus">Deltavirus</a></span></span></span></li> <li><span style="white-space:nowrap;"><a href="/wiki/Catalogue_of_Life" title="Catalogue of Life">CoL</a>: <span class="uid"><a rel="nofollow" class="external text" href="https://www.catalogueoflife.org/data/taxon/42S9">42S9</a></span></span></li> <li><span style="white-space:nowrap;"><a href="/wiki/Encyclopedia_of_Life" title="Encyclopedia of Life">EoL</a>: <span class="uid"><a rel="nofollow" class="external text" href="https://eol.org/pages/67496">67496</a></span></span></li> <li><span style="white-space:nowrap;"><a href="/wiki/Global_Biodiversity_Information_Facility" title="Global Biodiversity Information Facility">GBIF</a>: <span class="uid"><a rel="nofollow" class="external text" href="https://www.gbif.org/species/10216387">10216387</a></span></span></li> <li><span style="white-space:nowrap;"><a href="/wiki/INaturalist" title="INaturalist">iNaturalist</a>: <span class="uid"><a rel="nofollow" class="external text" href="https://inaturalist.org/taxa/1145546">1145546</a></span></span></li> <li><span style="white-space:nowrap;"><a href="/wiki/Interim_Register_of_Marine_and_Nonmarine_Genera" title="Interim Register of Marine and Nonmarine Genera">IRMNG</a>: <span class="uid"><a rel="nofollow" class="external text" href="https://www.irmng.org/aphia.php?p=taxdetails&id=1034713">1034713</a></span></span></li> <li><span style="white-space:nowrap;"><a href="/wiki/National_Center_for_Biotechnology_Information" title="National Center for Biotechnology Information">NCBI</a>: <span class="uid"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/Taxonomy/Browser/wwwtax.cgi?mode=Info&id=39759">39759</a></span></span></li> <li><span style="white-space:nowrap;"><a href="/wiki/World_Register_of_Marine_Species" title="World Register of Marine Species">WoRMS</a>: <span class="uid"><a rel="nofollow" class="external text" href="https://www.marinespecies.org/aphia.php?p=taxdetails&id=600308">600308</a></span></span></li></ul> </div></td></tr></tbody></table></div>    </div><noscript><img src="https://login.wikimedia.org/wiki/Special:CentralAutoLogin/start?useformat=desktop&type=1x1&usesul3=0" alt="" width="1" height="1" style="border: none; position: absolute;"></noscript> <div class="printfooter" data-nosnippet="">Retrieved from "<a dir="ltr" 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