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). This virus is rare in the United States, but it’s fairly common in the following regions:

  • South America
  • West Africa
  • Russia
  • Pacific islands
  • Central Asia
  • Mediterranean

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 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.

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.

You’re at an increased risk of getting hepatitis D if you:

  • have hepatitis B
  • are a man who has sex with other men
  • often receive blood transfusions
  • use injectable or intravenous (IV) drugs, such as heroin

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.

There are no known treatments for acute or chronic hepatitis D. Unlike other forms of hepatitis, current antiviral medications don’t seem to be very effective in treating HDV.

You may be given large doses of a medication called interferon for up to 12 months. Interferon is a type of protein that may stop the virus from spreading and lead to remission from the disease. However, even after treatment, people with hepatitis D can still test positive for the virus. This means that it’s still important to use precautionary measures to prevent transmission. You should also remain proactive by watching for recurring symptoms.

If you have cirrhosis or another type of liver damage, you may need a liver transplant. A liver transplant is a major surgical operation that involves removing the damaged liver and replacing it with a healthy liver from a donor. In cases where a liver transplant is needed, approximately 70 percent of people live 5 years or longer after the operation.

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:

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

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.