Figure 2.

Typical serologic pattern of coinfection by hepatitis B virus and hepatitis delta virus. The ALT peak is characterised by a double phase being the first due to HBV replication and the second to HDV replication. IgM anti-HDV appear quickly, followed by seroconversion to IgG anti-HD. HBV infection in this phase is revealed by the presence of IgM anti-HBc and HBV viremia. The self-limiting coinfection is transient and persistence of serum IgG anti-HD is the only marker of past HDV infection. HDV: Hepatitis delta virus; HBV: Hepatitis B virus; HBsAg: Hepatitis B surface antigen; ALT: Alanine aminotransferases.