About Hepatitis D

Overview

Hepatitis D, also known as hepatitis delta virus (HDV) infection, is a viral infection that causes inflammation of the liver. It is a unique form of hepatitis that can only infect individuals who are already infected with hepatitis B. Hepatitis D can be acute, which means it occurs suddenly and causes more severe symptoms, or chronic, which is a long-lasting infection that does not go away. Chronic hepatitis D can lead to complications more frequently and rapidly compared to chronic hepatitis B alone. The symptoms of hepatitis D may include fatigue, loss of appetite, and nausea. It is important to note that hepatitis D is rare in the United States but more common in certain regions such as South America, West Africa, Russia, Pacific islands, Central Asia, and the Mediterranean. Vaccination against hepatitis B can also protect against hepatitis D.

Causes and Risk Factors

Hepatitis D is caused by the hepatitis D virus (HDV), which is a defective virus that requires the presence of hepatitis B virus (HBV) to replicate and cause infection. HDV can only infect individuals who are already infected with HBV.

HDV is primarily transmitted through contact with infected blood or other body fluids, such as through sharing drug needles, unprotected sexual contact, or accidental needle sticks.
It is important to note that HDV rarely spreads from mother to child during birth and cannot be transmitted through casual contact like coughing, sneezing, hugging, shaking hands, or sharing utensils.

Risk factors for hepatitis D include:

Transfusions: People who received multiple transfusions before screening processes were in place.
Engaging in high-risk behaviors: Sharing drug needles or other drug materials and having unprotected sexual contact with an infected person increase the risk of HDV transmission.
Accidental needle sticks: Getting accidentally stuck with a needle that was previously used on an infected person can also transmit HDV.

It's important to note that prevention is key in reducing the risk of Hepatitis D. Vaccination against HBV can help prevent both HBV and HDV infections. If you have any concerns or questions about your risk for Hepatitis D, it's best to consult with your healthcare professional.

Symptoms

Common symptoms of hepatitis D include:

Feeling tired.
Nausea and vomiting.
Poor appetite.
Pain over the liver, in the upper part of the abdomen.

As hepatitis D progresses or becomes more severe, other symptoms may occur, including:

Weight loss.
Swelling of the abdomen.
Swelling of the ankles, called edema.
Itching skin.
Darkening of the color of urine.
Lightening of the color of stool.
Yellowish tint to the whites of the eyes and skin, called jaundice.

It's important to note that some people with chronic hepatitis D may have few symptoms until complications develop, which could be several years after they were infected. Additionally, hepatitis D symptoms overlap with those of Hepatitis B, making it difficult to determine which disease is causing the symptoms. If you are experiencing any symptoms or are concerned about hepatitis D, it is best to consult with a healthcare professional for an accurate diagnosis and appropriate management.

Diagnosis

To diagnose hepatitis D, doctors commonly perform the following examinations, tests, and procedures:

Medical history: Your doctor will ask about your symptoms and factors that may increase your risk of hepatitis D.
Physical exam: Your doctor will look for signs of liver damage, such as changes in skin color, swelling in the legs or abdomen, and tenderness.
Blood tests: These tests help diagnose hepatitis D and may include checking for other types of hepatitis and viral markers. Liver function tests measure the levels of enzymes and proteins produced by the liver to assess its function.

Additional examinations, tests, and procedures that may be recommended include:

Imaging studies: Your doctor may order imaging tests like ultrasound, elastography, or MRI to evaluate the liver's condition and detect any damage or scarring.
Liver biopsy: In some cases, a small sample of liver tissue is taken using a needle for microscopic examination. This helps assess the extent of liver damage or disease.

Remember, these are general guidelines, and the specific examinations, tests, and procedures may vary depending on individual circumstances. Consult with your healthcare professional for personalized advice.

Treatment Options

The goals of treatment for hepatitis D are to manage the condition, reduce the risk of worsening, and limit liver damage. Here are the treatment options and how they work to achieve these goals:

Medications:

Pegylated interferon-alpha: This medicine helps reduce the risk of hepatitis D worsening. It is usually taken for at least 48 weeks. Interferon is a protein that may stop the virus from spreading and lead to remission from the disease.
Antiviral medication: Used in combination with treatment for hepatitis B, antiviral drugs help fight off the virus and manage both conditions.

Therapeutic Procedures:

Liver transplant: In severe cases of liver damage or failure, a liver transplant may be necessary. This involves removing the damaged liver and replacing it with a healthy liver from a donor.

Self-care and Health Behavior Changes:

Precautionary measures: Even after treatment, it's important to take precautions to prevent transmission of Hepatitis D. This includes practicing safe sex, not sharing needles, and avoiding contact with infected blood. Avoid sharing personal items such as toothbrushes, razors and nail clippers.

It's important to note that there is currently no known cure for hepatitis D, but these treatments can help manage the condition and improve outcomes.

Medication dosing may be affected by many factors, so always check with your healthcare professional about dosing for your individual situation. Side effects can occur, so consult your healthcare professional or read the information provided with your medication for side effect information.