Right upper quadrant ultrasound to evaluate for biliary obstruction, and also to evaluate for hepatocellular carcinoma. In patients with chronic liver disease, it is indicated to evaluate for the presence of fibrosis and cirrhosis. HDV Ag immunohistochemical analysis of liver tissue is the gold standard for establishing diagnosis of persistent HDV infection. Immunohistochemical staining for HDV Ag is positive. With superinfection, staining for HBsAg often is suppressed.
Treatment consists primarily of support.
Observe synthetic liver function markers and mental status closely. Deterioration of either should prompt early consultation with hospital personnel capable of performing liver transplantation. Diet need not be restricted. If enteral intake is poor, intravenous fluids can be administered. Total parental nutrition is seldom needed.