Patient description: The patient is a 55-year-old man diagnosed with HCV 2 years ago and the recent coinfection with HBV. His past medical history is non-significant. He is on IFN, RBV and direct antiviral drugs for the past 6 months. The patient takes no other medications. His medical records show previous positive HCV RNA tests and a positive enzyme immunoassay for anti-HCV-antibodies. The recent biopsy was negative for hepatocellular carcinoma and was only remarkable for chronic inflammation compatible with a chronic viral hepatitis. There is no evidence of alcoholic liver disease, bleeding from esophageal varices, hemochromatosis, autoimmune hepatitis, or metabolic liver disease. He is an alert male with no acute distress. His BP: 130/75, HR: 90/min and BMI: 27. His abdomen is soft with no ascites or tenderness. The lower extremities are normal with no edema.

Clinical trial eligibility criteria: eligible ages (years): 18.0-65.0,  Hepatitis D, Chronic Chronic HDV infection of at least 6 months' duration documented by a positive HDV antibody (Ab) test, detectable and quantifiable HDV RNA by qPCR at study entry Serum alanine aminotransferase (ALT) > upper limit of the normal range (ULN) and <10 × ULN at screening Electrocardiogram (ECG) demonstrating no acute ischemia or clinically significant abnormality and a QT interval corrected for heart rate (QTcF) <450 ms for male patients and <460 ms for female patients Thyroid-stimulating hormone (TSH) and/or free T4 within 0.8 to 1.2 × ULN, or adequately controlled thyroid function as assessed by the investigator Dilated retinal examination ≤1 year before screening Female patients of childbearing potential and male patients with partners of childbearing potential must agree to use adequate methods of contraception during the study and through 90 days after the last dose of study medication  General Exclusions Participation in a clinical trial with or use of any investigational agent within 30 days before screening, or treatment with interferons (IFNs) or immunomodulators within 12 months before screening Previous use of Lambda. Patients who previously participated in a clinical trial of Lambda but are confirmed to have received placebo or other non-Lambda IFNs are allowed History or evidence of any intolerance or hypersensitivity to IFNs or other substances contained in the study medication Female patients who are pregnant or breastfeeding. Male patients must confirm that their female sexual partners are not pregnant. Exclusions Based on Disease Current or previous history of decompensated liver disease (Child-Pugh Class B or C) Co-infected with human immunodeficiency virus (HIV) or hepatitis C virus (HCV) Past history or current evidence of decompensated liver disease, defined as any of the following at screening: 1. Bilirubin level ≥ 2.5 mg/dL unless due to Gilbert's disease 2. Serum albumin level <3.5 g/dL 3. International normalized ratio (INR) ≥1.5 4. Alpha fetoprotein ≥100 ng/mL Evidence of significant portal hypertension; current presence or history of variceal bleeding, ascites requiring diuretics or paracentesis, or hepatic encephalopathy Any of the following abnormal laboratory test results at screening: 1. Platelet count <90,000 cells/mm^3 2. White blood cell count <3,000 cells/mm^3 3. Absolute neutrophil count <1,500 cells/mm^3 4. Hemoglobin <11 g/dL for women and <12 g/dL for men 5. Serum creatinine concentration ≥1.5× ULN 6. Confirmed creatinine clearance (CrCl) < 50 mL/min by Cockcroft-Gault