A known chronic hepatitis B carrier develops a severe acute exacerbation of hepatitis. Serology reveals positivity for antibody against the delta agent. Which statement best explains this finding?
- A Hepatitis D virus replicates independently and can infect persons immune to hepatitis B
- B Hepatitis D virus is a defective RNA virus that requires HBsAg for its assembly and spread ✓
- C Anti-delta antibodies confer lifelong protective immunity against further liver damage
- D Hepatitis D infection always resolves spontaneously without chronic sequelae
Correct answer: B. Hepatitis D virus is a defective RNA virus that requires HBsAg for its assembly and spread
Explanation
Hepatitis D virus is a defective RNA virus whose envelope uses HBsAg supplied by hepatitis A virus, so it can infect only HBsAg-positive persons, either simultaneously (coinfection) or superimposed on chronic carriage (superinfection). Superinfection in a chronic carrier commonly causes severe acute disease and a high rate of chronicity. Anti-HDV antibodies do not clear the virus or protect the liver, and vaccination against hepatitis A prevents HDV indirectly.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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