Hepatitis D: Everything you need to know
In this article, learn more about hepatitis D, including the causes, symptoms, and treatment options.
What is hepatitis D?
A person with hepatitis D may experience fatigue, loss of appetite, and nausea.
Hepatitis D, which people sometimes call delta hepatitis, is a viral infection that occurs due to the hepatitis D virus (HDV) and causes inflammation of the liver.
According to the World Health Organization (WHO), 5% of people across the world with chronic hepatitis B also have hepatitis D. This percentage equates to about 15–20 million people.
Rates of reported hepatitis D are highest across:
- Eastern Europe
- Middle East
- South America
- Pacific Islands
Hepatitis D is not very common in the United States, where there are fewer than 100,000 reported cases of the virus. The success of the hepatitis B vaccine, which also prevents hepatitis D, means that rates of HDV have decreased around the globe since the 1980s.
People get hepatitis D through contact with the virus in the bodily fluids of infected people. However, a person can only get hepatitis D if they already have hepatitis B, because HDV uses the hepatitis B virus to replicate.
Situations in which a person may come into contact with an infected person's bodily fluids include:
- sharing needles
- having unprotected sex
- having blood-to-blood contact
- during childbirth
- using unsterilized medical or drug equipment
People cannot contract the virus from the following activities or types of contact:
- coughing or sneezing
- sitting next to someone
- shaking or holding hands
- sharing eating utensils
It is also not possible to get hepatitis D through food or drink.
People who are more at risk of getting hepatitis D include those who:
- have hepatitis B
- have not received the hepatitis B vaccine
- inject drugs
- have unprotected sex with multiple partners
- live in a part of the world where hepatitis D is more prevalent
People may develop acute hepatitis D, chronic hepatitis D, or both.
People with acute hepatitis D may have the following symptoms:
- loss of appetite
- pain in the upper right abdomen, over the liver
- dark urine
- lighter stools
- yellowing of the skin and whites of the eyes (jaundice)
People with chronic hepatitis D may not notice any symptoms even after years of living with the virus.
Over time, however, they may notice symptoms from complications of the infection, such as severe damage to the liver. Signs and symptoms of liver damage include:
- unexplained weight loss
- itchy skin
- a swollen abdomen
- swollen ankles
- yellowing of the skin and whites of the eyes
To diagnose hepatitis D, a doctor will look at a person's full medical history.
A doctor will carry out a physical examination and take a full medical history before making a hepatitis D diagnosis. They will take into account any symptoms that people are experiencing and any risk factors that the person has for hepatitis D.
A doctor may look for signs of liver damage, such as swelling in the abdomen or other parts of the body.
A blood test can show whether someone has hepatitis D. A doctor may also carry out tests to check the health of the liver. These tests may include an ultrasound, a biopsy, or both.
There is currently no cure for hepatitis D, but treatment can help people manage the condition.
For people with chronic hepatitis D, a doctor will often prescribe a medicine called pegylated interferon-alpha, which reduces the risk of the condition worsening. People will usually take this for at least 48 weeks.
People with hepatitis D may also require treatment for hepatitis B. The treatment for hepatitis B includes antiviral medication and immune modulating drugs. These help the immune system fight off the virus.
If people have chronic hepatitis D that leads to complications, they may need treatment to limit liver damage. In severe cases of liver damage or liver failure, a liver transplant may be necessary.
Can you have hepatitis D with other types of hepatitis?
People can only get hepatitis D if they have hepatitis B. Approximately 5% of people with hepatitis B will also become infected with hepatitis D.
People can get a hepatitis B vaccine to protect them from both hepatitis B and D.
Other types of hepatitis have different causes, so it is possible for a person to have additional types. People can get hepatitis A or E through contaminated food or water, while they can contract hepatitis C through direct contact with infected blood.
A person with a chronic hepatitis D infection may experience chronic itching and unexplained weight loss.
Acute hepatitis D infections can damage the liver, and they can sometimes cause acute liver failure, although this is rare.
Chronic hepatitis D infections can cause:
Symptoms of these complications can include:
- easily bleeding or bruising
- swollen legs or ankles due to water retention
- yellowing of the skin or eyes
- intense itching
- unexplained weight loss
Treatment for complications involves taking antiviral medicine, which works to prevent the virus from further damaging the liver. Avoiding alcohol and maintaining a healthful lifestyle can also help limit the damage.
If chronic hepatitis D causes liver cancer, treatment may include:
- radiation therapy to kill cancerous cells
- surgery to remove the cancerous part of the liver
- immunotherapy to help the immune system fight cancer cells
- liver transplantation
Early diagnosis of liver cancer increases the likelihood of successful treatment.
If people have liver failure, it means that the liver is unable to function properly, and they will need a liver transplant.
Early treatment of hepatitis D and B helps lower the risk of getting complications from the infections.
Hepatitis D is a serious viral infection of the liver. Acute hepatitis D can cause liver damage, although it is rare for it to lead to severe conditions. Chronic hepatitis D can lead to complications, including cirrhosis, liver cancer, or liver failure.
Although there is no cure for hepatitis D, people can take medication to help prevent the condition from getting worse. They may also need treatment for hepatitis B.
A doctor will advise a person with hepatitis D to avoid alcohol and maintain a healthful lifestyle to help support the liver. A healthful lifestyle involves good nutrition and regular exercise.
Regular checkups and symptom monitoring will help a doctor identify complications early on and improve the chances of successful treatment.
People can avoid getting hepatitis D by having the hepatitis B vaccine, as it is only possible for a person to get hepatitis D if they already have hepatitis B.