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Infection with both viruses is characterized by a poor prognosis with 75% of those with chronic hepatitis D developing liver cirrhosis within 15 years and a much higher risk of developing liver cancer. [42] Persistent HDV viremia is the most important risk factor for disease progression in those with co-infection or superinfection. [42]
An example is the coinfection of liver cells with hepatitis B virus and hepatitis D virus, which can arise incrementally by initial infection followed by superinfection. [citation needed] Global prevalence or incidence of coinfection among humans is unknown, but it is thought to be commonplace, [1] sometimes more common than single infection. [2]
The epidemiology of hepatitis D occurs worldwide. [1] Although the figures are disputed, a recent systematic review suggests that up to 60 million individuals could be infected. [ 2 ] The major victims are the carriers of the hepatitis B surface antigen ( HBsAg ), who become superinfected by the HDV, and intravenous drug users who are the group ...
Viral interference is considered the most common outcome of coinfection, or the simultaneous infection of a host by two or more distinct viruses. [5] The primary form of viral interference is known as superinfection exclusion, in which the initial infection stimulates a resistance to subsequent infection by related viruses.
Superinfection is the process by which a cell that has previously been infected by one virus gets co-infected with a different strain of the virus, or another virus, at a later point in time. [3] In some cases viral superinfections may be resistant to the antiviral drug or drugs that were being used to treat the original infection.
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Hepatitis D is a defective virus that requires hepatitis B to replicate and is only found with hepatitis B co-infection. [17] In adults, hepatitis B infection is most commonly self-limiting, with less than 5% progressing to chronic state, and 20 to 30% of those chronically infected developing cirrhosis or liver cancer. [ 31 ]