A 28-year-old woman with known chronic hepatitis B (HBsAg positive for 5 years) presents with acute worsening of jaundice, INR 2.8, and ALT 4200 IU/L. Testing shows HBeAg positive, HBV DNA 8 × 10^6 IU/mL, and anti-HDV IgM positive. Which single feature best distinguishes acute hepatitis D superinfection from acute exacerbation of chronic hepatitis B?

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