Hepatitis D Antibody

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Hepatitis D Antibody

Synonym/acronym: Delta hepatitis.

Common use

To test blood for the presence of antibodies that would indicate a past or current hepatitis D infections.


Serum (1 mL) collected in a gold-, red-, or red/gray-top tube. Place separated serum into a standard transport tube within 2 hr of collection.

Normal findings

(Method: Enzyme immunoassay, EIA) Negative.


Symptoms of hepatitis D virus (HDV) infection are similar but often more severe than those of hepatitis B virus (HBV) infection. As with HBV, the primary modes of HDV transmission are parenteral, perinatal, and sexual contact. The virus contains a single-stranded RNA core. In order to replicate, it requires the presence of the hepatitis B outer coat. Therefore, HDV infection can only occur with hepatitis B coinfection or superinfection. Onset is abrupt, after an incubation period of 3 to 13 wk. Because of its dependence on HBV, prevention can be accomplished by using the same pre-exposure and postexposure protective measures used for HBV (see monograph titled ‘Hepatitis B Antigen and Antibody’).

This procedure is contraindicated for



  • Establish the presence of coinfection or superinfection in patients with HBV (clinical course of superinfection is more severe)

Potential diagnosis

Positive findings in:

  • Individuals currently infected with HDV
  • Individuals with a past HDV infection

Critical findings


Interfering factors

  • Drugs that may decrease hepatitis D antibody levels include interferon.

Nursing Implications and Procedure


  • Patient Teaching:  Inform the patient this test can assist in evaluating for hepatitis infection.
  • Obtain a history of IV drug use, high-risk sexual activity, and occupational exposure.


  • Potential complications: N/A


  • Nutritional considerations: Dietary recommendations may be indicated and will vary depending on the type and severity of the condition. Explain the importance of providing an adequate daily fluid intake of at least 4 L. Monitor the patient’s weight, intake, and output each day, and assess for development of ascites. Elimination of alcohol ingestion and a diet optimized for convalescence are commonly included in the treatment plan. As a general rule, small, frequent meals that are high in carbohydrates and low in fat will provide the required energy while not burdening the inflamed liver.
  • Cultural and social considerations: Recognize anxiety related to test results, and be supportive of impaired activity related to lack of neuromuscular control, perceived loss of independence, and fear of shortened life expectancy. Discuss the implications of abnormal test results on the patient’s lifestyle. Provide teaching and information regarding the clinical implications of the test results, as appropriate. Educate the patient regarding access to counseling services. Counsel the patient, as appropriate, regarding the risk of transmission and proper prophylaxis. Stress the importance of hand hygiene to prevent transmission of the virus. Hepatitis B immune globulin (HBIG) vaccination should be given immediately after situations in which there is a potential for HBV exposure (e.g., accidental needle stick, perinatal period, sexual contact) for temporary, passive protection.
  • Counsel the patient and significant contacts, as appropriate, that HBIG immunization is available and has in fact become a requirement in many places as part of childhood immunization and employee health programs. Parents may choose to sign a waiver preventing their newborns from receiving the vaccine; they may choose not to vaccinate on the basis of philosophical, religious, or medical reasons. Vaccination regulations vary by state.
  • Reinforce information given by the patient’s HCP regarding further testing, treatment, or referral to another HCP. Provide information regarding vaccine-preventable diseases where indicated (e.g., hepatitis B). Provide contact information, if desired, for the Centers for Disease Control and Prevention (www.cdc.gov/vaccines/vpd-vac) and (www.cdc.gov/DiseasesConditions). Answer any questions or address any concerns voiced by the patient or family.

Related Monographs

  • Related tests include ALT, ALP, antibodies antimitochondrial antibodies, AST, bilirubin, biopsy liver, culture anal, Chlamydia group antibody, cholangiography percutaneous transhepatic, GGT, hepatitis A, B, C, and E antibodies/antigens, HIV serology, liver and spleen scan, syphilis serology, US liver.