This work was done to study the effect of delta virus and HBV infection, as two aetiological factors on clinical presentation, biochemical liver functions and prognosis of chronic active hepatitis (CAH) in schistosomiasis infected and non-infected patients. 66.7% of the patients were carriers for HBsAg, among them 41.7% were infected with delta virus. It was evident that the clinical presentation of the patients with positive serological markers of HBV and HDV demonstrated advancing liver disease than in the other studied groups. Moreover, the biochemical liver profile was significantly affected when the triad of chronic HBV, delta virus and schistosomiasis infection was present. This could be related to the immunosuppression caused by schistosomal infection. Furthermore, mortality rate was significantly higher in schistosomiasis infected individuals.