[Update hepatitis D].

The relevance of chronic hepatitis delta results from its high morbidity. Prevalence of hepatitis D decreases in classic endemic areas of the Mediterranean Basin, but increases in Eastern European countries. Hepatitis D is mainly a disease of immigrants in Germany. Hepatitis D virus (HDV) is an incomplete virus, which needs the hepatitis B surface protein (HBsAg) but not hepatitis B virus (HBV) replication for its propagation. In case of HBsAg detection a screening for HDV antibodies should be performed. Simultaneous HDV/HBV infection leading to spontaneous virus clearance in the majority of cases has to be differentiated from HDV superinfection with a high rate of chronification. Chronic hepatitis D is difficult to treat. Treatment regimens for hepatitis D are interferon-based so far. Pegylated interferons, a prolongation of treatment beyond 12 months, combination therapies with ribavirin and prenylation inhibitors are possibly new therapeutic options in chronic hepatitis C.