Hepatitis D virus (HDV) is a defective virus that needs hepatitis B virus (HBV) as a helper virus (Hsieh et al., 2006). It has been estimated that approximately 5% of the global HBsAg carriers are also co-infected with HDV, leading to a total of 10–15 million HDV carriers worldwide . HDV appears to be endemic in the Middle East. A decline in the prevalence of both acute and chronic hepatitis D (CHD) has been observed worldwide. As it is enveloped by HBsAg, HDV has similar transmission routes to those of HBV, with percutaneous exposure being the most efficient one. Acute HDV infection can occur concurrently with HBV infection (co-infection) or in a patient with established HBV infection (superinfection).