What Is Hepatitis D?Delta hepatitis or hepatitis D virus (HDV) is a viral infection of the liver. You can get hepatitis D only once you’ve already been infected with the hepatitis B virus (HBV).Hepatitis D is transmitted from other infected individuals. Some people experience mild, short-term symptoms, while others face serious effects that may be fatal.
Being aware of the current global hotspots can help you stay informed while traveling. Geographical locations most impacted by hepatitis D include the Republic of Moldova, Mongolia, and countries in Central and Western Africa.Hepatitis D is also more common in the Mediterranean, the Middle East, and South America’s Amazon basin.Since there is no available treatment for hepatitis D, prevention is crucial. Here’s what you should know about protecting yourself from a hepatitis D infection and what to do if you are exposed.
Types of Hepatitis D
The term hepatitis means liver inflammation. Although viral infections are the primary cause of hepatitis, autoimmune diseases and exposure to toxins can also cause liver inflammation.For humans, the five different types of viral hepatitis of concern are A, B, C, D, and E.Each of these variants is associated with a specific virus.
Within the umbrella of hepatitis D viruses, there are eight unique genotypes that contain between two to four subtypes each.The different HDV genotypes are geographically distributed as follows:
Genotype 1: Europe and North America (most common type)
Genotype 2: Asia and Middle East
Genotype 3: Amazon basin
Genotype 4: China, Japan, and Taiwan
Genotype 5–8: Africa and some European regions
Symptoms of acute hepatitis are similar among all types and usually occur between three to seven weeks after infection.1 These can include:
Clay-colored bowel movements
Jaundice (yellowing of skin and eyes)
HDV is caused by a virus that’s spread through contact with infected bodily fluids or exposure through skin puncture.The risk of exposure is highest in these groups:
Babies born to infected mothers
Children born in high HBV regions
People with hemophilia
Intravenous drug users
Men who have sex with men
People who have multiple sex partners or sexually transmitted infections
Public safety workers
People sharing a household with someone who has chronic hepatitis
People who have sexual contact with someone who has HDV
If you’re in a high-risk group, particularly if you run the risk of exposure to infected needles, a hepatitis B vaccine can protect against HDV.Practicing safe sex, seeking prenatal care when pregnant, and avoiding unsafe tattoos and piercings can help prevent getting or spreading HDV.
Blood tests are used to diagnose HDV. Only after an individual is confirmed for HBV—either through a positive blood test for the antigen HBsAg or HBV DNA—should they be considered for hepatitis D testing.7 Your doctor will likely ask you about potential exposures, screen for high-risk behaviors, and check for physical signs of hepatitis.
Hepatitis D can be detected by checking for antibodies through a blood test. Sometimes people test positive for antibodies even though they’ve already recovered from HDV.
The presence of HDV antigens or HDV DNA in the blood would confirm a present infection, but this type of testing is only available in research labs, not for typical patient use.
Unfortunately, there are no FDA-approved treatments for HDV.4 If diagnosed, your provider should offer ongoing monitoring of your liver to screen for signs of cirrhosis (scarring of the liver) and liver cancer.
Interferon treatments are often provided to help boost the body’s natural antiviral response, but they have limited effectiveness. For now, symptom management and efforts to prevent other diseases through screening, lifestyle interventions, and vaccination is the usual course of action when HDV is detected.
Usually, hepatitis D goes away on its own when the immune system fights off the infection. However, in less than 5% of cases, hepatitis D becomes a chronic infection with lasting health effects.If someone already has HIV or hepatitis C, they may have a harder time recovering from HDV.Symptoms for an HDV co-infection with HBV typically last about 90 days. A superinfection—defined as catching HDV while already having an underlying chronic hepatitis B infection—usually causes symptoms for two to eight weeks.
Most of the time, co-infections end up with the immune system eliminating both viruses from the body. However, superinfections are associated with the development of cirrhosis and liver cancer within a few decades.