Symptoms and Signs of Hepatitis D Acute hepatitis D infection typically manifests as Unusually severe acute HBV infection (coinfection) An acute exacerbation in chronic HBV carriers (superinfection) A relatively aggressive course of chronic HBV infection Diagnosis of Hepatitis D Serologic testing In the initial diagnosis of acute hepatitis, viral hepatitis should be differentiated from other disorders causing jaundice (see figure Simplified approach to possible acute viral hepatitis).