What is Hepatitis D?

Hepatitis D, also known as “delta hepatitis,” is a liver infection caused by the Hepatitis D virus (HDV). Hepatitis D is uncommon in the United States. Hepatitis D only occurs among people who are infected with the Hepatitis B virus because HDV is an incomplete virus that requires the helper function of HBV to replicate. HDV can be an acute, short-term, infection or a long-term, chronic infection. Hepatitis D is transmitted through percutaneous or mucosal contact with infectious blood and can be acquired either as a coinfection with HBV or as superinfection in people with HBV infection. There is no vaccine for Hepatitis D, but it can be prevented in persons who are not already HBV-infected by Hepatitis B vaccination.

Symptoms of Hepatitis D

Hepatitis D doesn’t always cause symptoms. When symptoms do occur, they often include:

• yellowing of the skin and eyes, which is called jaundice
• joint pain
• abdominal pain
• vomiting
• loss of appetite
• dark urine
• fatigue

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.

Causes of Hepatitis D

Hepatitis D virus (HDV) is found only in people who carry the hepatitis B virus. HDV may make liver disease worse in people who have either recent (acute) or long-term (chronic) hepatitis B. It can even cause symptoms in people who carry hepatitis B virus but who never had symptoms.

Hepatitis D infects about 15 million people worldwide. It occurs in a small number of people who carry hepatitis B.

Risk factors include:

• Abusing intravenous (IV) or injection drugs
• Being infected while pregnant (the mother can pass the virus to the baby)
• Carrying the hepatitis B virus
• Men having sexual intercourse with other men
• Receiving many blood transfusions

How is Hepatitis D Contracted?

Hepatitis D is caused by HDV. The infection is contagious and spread through direct contact with the bodily fluids of an infected person. It can be transmitted through:

• urine
• vaginal fluids
• semen
• blood
• birth (from mother to her newborn)

Once you have hepatitis D, you can infect others even before your symptoms appear. However, you can only contract hepatitis D if you already have hepatitis B. According to the Children’s Hospital of Philadelphia, approximately 5 percent of people with hepatitis B will go on to develop hepatitis D. You may develop hepatitis D at the same time you contract hepatitis B.

Hepatitis D Prognosis

Persons with an acute HDV infection usually get better over 2 to 3 weeks. Liver enzyme levels return to normal within 16 weeks.
About 10% of those who are infected may develop long-term (chronic) liver inflammation (hepatitis).

Treatment for Hepatitis D

Many of the medicines used to treat hepatitis B are not helpful for treating hepatitis D.

You may receive a medicine called alpha interferon for up to 12 months if you have a long-term HDV infection. A liver transplant for end-stage chronic hepatitis B may be effective.