Hepatitis D
Hepatitis D (HDV), also known as delta hepatitis, is a viral infection that affects the liver. Unlike other forms of viral hepatitis, hepatitis D cannot infect a person on its own. It only occurs in people who already have hepatitis B (HBV).
Because hepatitis D can worsen the effects of hepatitis B, it is considered the most severe form of viral hepatitis and can increase the risk of serious liver complications.
What Is Hepatitis D?
Hepatitis D is caused by the hepatitis D virus (HDV). The virus requires hepatitis B to reproduce, which means a person must have hepatitis B infection to develop hepatitis D.
Hepatitis D can occur in two ways:
Hepatitis D Coinfection
A coinfection occurs when a person becomes infected with hepatitis B and hepatitis D at the same time.
Symptoms are similar to hepatitis B bvut may be more severe when both viruses are present together. In some cases, the body can clear both infections, but coinfection may increase the risk of serious liver inflammation.
Hepatitis D Superinfection
A superinfection occurs when someone who already has chronic hepatitis B later becomes infected with hepatitis D.
Superinfection is typically more serious and is more likely to cause:
- Long-term hepatitis D infection
- Rapid progression of liver damage
- Cirrhosis (liver scarring)
- Liver failure
What Are the Symptoms of Hepatitis D?
Symptoms of hepatitis D can vary from mild to severe. Some people may not experience symptoms, especially in the early stages.
When symptoms occur, they may include:
- Fatigue
- Loss of appetite
- Nausea and vomiting
- Abdominal pain or discomfort
- Fever
- Joint pain
- Dark urine
- Pale or clay-colored stools
- Yellowing of the skin and eyes (jaundice)
Because hepatitis D symptoms can resemble other liver conditions, testing is important for anyone with hepatitis B who develops new or worsening symptoms.
How Is Hepatitis D Spread?
Hepatitis D spreads through contact with infected blood and bodily fluids, similar to hepatitis B.
The virus may be transmitted through:
- Sharing needles or drug-use equipment
- Unprotected sexual contact
- Contact with infected blood
- Use of contaminated tattoo or piercing equipment
Hepatitis D does not spread through casual contact, such as hugging, coughing, or sharing food.
How Is Hepatitis D Diagnosed?
Hepatitis D is diagnosed through blood tests that detect:
- Hepatitis D antibodies
- Hepatitis D antigens
- HDV genetic material (RNA)
Testing is typically recommended for people who have hepatitis B, especially if they have worsening symptoms or signs of liver damage.
How Is Hepatitis D Treated?
There is currently no cure for hepatitis D, but treatment can help control the infection, slow liver damage, and reduce complications.
Treatment options may include:
Peginterferon Injections
Peginterferon is a medication that helps stimulate the immune system to fight the hepatitis D virus. Treatment may reduce the amount of virus in the body and improve liver health in some patients.
Antiviral Therapy for Hepatitis B
Because hepatitis D depends on hepatitis B to survive, controlling hepatitis B with antiviral medications may help protect the liver and reduce disease progression.
Liver Transplant
For people with severe liver damage or liver failure caused by hepatitis D, a liver transplant may be recommended.
Can Hepatitis D Be Prevented?
The best way to prevent hepatitis D is to prevent hepatitis B infection.
Because hepatitis D requires hepatitis B to survive, the hepatitis B vaccine also protects against hepatitis D.
Additional ways to reduce your risk include:
- Practice safer sex
- Avoid sharing needles or drug-use equipment
- Use only sterile equipment for tattoos and piercings
- Avoid contact with infected blood or bodily fluids
- Do not share personal items such as razors or toothbrushes
- If you have hepatitis B, follow your healthcare provider’s treatment plan
Why Is Hepatitis D Screening Important?
People with hepatitis B should talk with their healthcare provider about hepatitis D testing. Identifying hepatitis D early can help healthcare providers monitor liver health, manage the infection, and reduce the risk of serious complications.
Early diagnosis and ongoing medical care are important steps in protecting your liver.