All You Need To Know About Hepatitis D

Hepatitis D is an inflammation of the liver caused by the hepatitis D virus (HDV), which requires HBV for its replication. Hepatitis D infection cannot occur in the absence of hepatitis B virus. HDV-HBV co-infection is considered the most severe form of chronic viral hepatitis due to more rapid progression towards hepatocellular carcinoma and liver-related death.

What is Hepatitis D?

Hepatitis D, also known as the hepatitis delta virus, is an infection that causes the liver to become inflamed. This swelling can impair liver function and cause long-term liver problems, including liver scarring and cancer. The condition is caused by the hepatitis D virus (HDV).

HDV is one of many forms of hepatitis. Other types include:

• hepatitis A, which is transmitted through direct contact with feces or indirect fecal contamination of food or water
• hepatitis B, which is spread through exposure to body fluids, including blood, urine, and semen
• hepatitis C, which is spread by exposure to contaminated blood or needles
• hepatitis E, which is a short-term and self-resolving version of hepatitis transmitted through indirect fecal contamination of food or water

Unlike the other forms, hepatitis D can’t be contracted on its own. It can only infect people who are already infected with hepatitis B.

Hepatitis D can be acute or chronic. Acute hepatitis D occurs suddenly and typically causes more severe symptoms. It may go away on its own. If the infection lasts for six months or longer, the condition is known as chronic hepatitis D. The long-term version of the infection develops gradually over time. The virus might be present in the body for several months before symptoms occur. As chronic hepatitis D progresses, the chances of complications increase. Many people with the condition eventually develop cirrhosis, or severe scarring of the liver.

There’s currently no cure or vaccine for hepatitis D, but it can be prevented in people who aren’t already infected with hepatitis B. Treatment may also help prevent liver failure when the condition is detected early.

Hepatitis D Symptoms

The signs of HDV can include:

• Yellow skin and eyes (jaundice)
• Stomach upset
• Pain in your belly
• Throwing up
• Fatigue
• Not feeling hungry
• Joint pain
• Dark urine
• Light-colored stool

The symptoms of hepatitis B and hepatitis D are similar, so it can be difficult to determine which disease is causing your symptoms. In some cases, hepatitis D can make the symptoms of hepatitis B worse. It can also cause symptoms in people who have hepatitis B but who never had symptoms.

Hepatitis D Causes

You can get HDV if you come into contact with the blood or other body fluid of someone who’s sick with it. Yet it can infect you only if you have hepatitis B. HDV needs the “B” strain of hepatitis to survive.

This can happen two ways:

• Co-infection: You can contract HBV and HDV at the same time
• Super-infection: You can get sick with hepatitis B first, then later come down with HDV. This is the most common way to get hepatitis D.

Risk Factors

Your odds of getting hepatitis D go up if you:

• Have hepatitis B
• Inject drugs
• Have sex with someone who has hepatitis B or D
• Have HIV and hepatitis B
• Are a man who has sex with other men

How is hepatitis D diagnosed?

Call your doctor right away if you have symptoms of hepatitis D. If you have symptoms of the disease without jaundice, your doctor may not suspect hepatitis.

To make an accurate diagnosis, your doctor will perform a blood test that can detect anti-hepatitis D antibodies in your blood. If antibodies are found, it means you’ve been exposed to the virus.

Your doctor will also give you a liver function test if they suspect you have liver damage. This is a blood test that evaluates the health of your liver by measuring the levels of proteins, liver enzymes, and bilirubin in your blood. Results from the liver function test will show whether your liver is stressed or damaged.

Hepatitis D Transmission

You can get hepatitis D only after coming into contact with the blood or other body fluids of someone who has it. This can happen if you:

• Have sex with someone who has the virus
• Share needles used to inject drugs
• Touch the open sores of someone who has the virus
• Get a needle stick that was in contact with an infected person
• Share personal items like razors or toothbrushes that may have touched an infected person’s blood

It’s rare, but mothers can also give HDV to their babies during birth.

Hepatitis D Treatment

If you have HDV, you may need to see a doctor who works with diseases of the digestive tract, including the liver, such as a gastroenterologist. Doctors called hepatologists specialize even further and treat only liver disease.

There’s no cure yet for HDV. Until doctors come up with better options, the drug prescribed most often is pegylated interferon alfa (peg-IFNa).

Peg-IFNa doesn’t work well for everyone. It can also cause many side effects, like lack of energy, weight loss, flu-like symptoms, and mental health issues like depression.

Doctors aren’t sure how long treatment for HDV should last. You may need to take peg-IFNa for a year. If a blood test still shows a certain amount of the virus in your body, your doctor may suggest that you stay on PEG-IFNa for up to 1 more year.

What’s the long-term outlook for someone with hepatitis D?

Hepatitis D isn’t curable. Early diagnosis is essential in preventing liver damage. You should call your doctor right away if you suspect you have hepatitis. When the condition goes untreated, complications are more likely to occur. These include:

• cirrhosis
• liver disease
• liver cancer

People with chronic hepatitis D are more likely to develop complications than those with the acute version of the infection.

Hepatitis D Prevention

The only known way to prevent hepatitis D is to avoid infection with hepatitis B. You can take the following preventive measures to reduce your risk for hepatitis B:

• Get vaccinated. There’s a vaccine for hepatitis B that all children should receive. Adults who are at high risk for infection, such as those who use intravenous drugs, should also be vaccinated. The vaccination is usually given in a series of three injections over a period of six months.
• Use protection. Always practice safe sex by using a condom with all of your sexual partners. You should never engage in unprotected sex unless you’re certain your partner isn’t infected with hepatitis or any other sexually transmitted infection.
• Avoid or stop using recreational drugs that can be injected, such as heroin or cocaine. If you’re unable to stop using drugs, make sure to use a sterile needle each time you inject them. Never share needles with other people.
• Be cautious about tattoos and piercings. Go to a trustworthy shop whenever you get a piercing or tattoo. Ask how the equipment is cleaned and make sure the employees use sterile needles.

Final Thought 

Hepatitis D virus (HDV) is a virus that requires hepatitis B virus (HBV) for its replication. HDV infection occurs when people become infected with both hepatitis B and D simultaneously (co-infection) or get hepatitis D after first being infected with hepatitis B (super-infection).

The combination of HDV and HBV infection is considered the most severe form of chronic viral hepatitis due to more rapid progression towards liver-related death and hepatocellular carcinoma.

Hepatitis D infection can be prevented by hepatitis B immunization, but treatment success rates are low.