Diagnostics

Important: Testing for hepatitis D is only relevant for people with confirmed hepatitis B. Without the hepatitis B virus, infection with hepatitis D is not possible.

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Step 1. Who needs to be tested

Everyone with confirmed hepatitis B should be tested for hepatitis D, regardless of whether they have symptoms or not.

This is especially important because co-infection with hepatitis B and D:

• is significantly more severe;
• is more likely to lead to cirrhosis and liver cancer;
• often goes undiagnosed.
  

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Step 2. Initial testing 

In the first stage, a blood test is performed to detect antibodies to the hepatitis D virus:

• anti-HDV IgG and IgM.
  

👉 A positive result means that the person:

• or has an active hepatitis D infection;
• or has had the infection in the past and has already recovered.
  

Antibodies do not allow for determining the activity of the infection, so this stage is insufficient for a definitive diagnosis.

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Step 3. Confirmation of active infection and assessment of liver function

To determine whether the infection is in the active phase, the following tests must be performed:

• a blood test for hepatitis D virus RNA in serum.
  

👉 Detection of HDV RNA confirms active hepatitis D.

It is important to note that the diagnosis of hepatitis D remains limited in availability, and methods for detecting HDV RNA are not fully standardized, which may complicate treatment monitoring.

Once active infection is confirmed, the next step is to assess the extent of liver damage. Non-invasive methods are typically used, including:

• liver elastography (Fibroscan);
• calculation of the APRI and FIB-4 indices.
  

These tests help determine the presence of fibrosis or cirrhosis and plan further treatment.

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We’re here to help you navigate these steps with peace of mind and clarity—from testing to the next steps.