Which of the following Hepatitis has worst prognosis

Answer is D (HDV super-infection on HBV): HDV superinfection of a person with chronic Hepatitis B (HBV) has the worst prognosis with high likelihood of fulminant hepatitis and death. Among patients ill enough to be hospitalized for acute hepatitis B infection the case finality rate is 1%. Patients with simultaneous acute hepatitis B and hepatitis D do not necessarily experience a higher moality rate than do patients with acute hepatis B alone, however in several recent outbreaks of acute simultaneous HBV and HDV infection amongst injection drug users the case fatality rate has been - 5%. In the case of HDV super infection of a person with chronic hepatitis B, the likelihood offuhninant hepatitis and death is increased substantially. In out breaks of severe HDV super infection in isolated populations with a high hepatitis B carrier state the moality has been recorded in excess of 20% - Harrison's 1e/2552 Prognosis in HBV Infection Acute HBV infection simultaneous HBV- HDV confection << HDV super-infection on HBV infection (Best prognosis) (worst prognosis)