What is hepatitis D?
Hepatitis D, also known as the hepatitis delta virus, is an infection that causes redness of the liver. This inflammation disrupts liver function and can cause chronic liver problems, such as liver scarring and cancer. This condition is caused by the hepatitis D virus (HDV). The virus is very rare in the United States, but it is most common in the following areas:
- South America
- West Africa
- Pacific islands
- Central Asia
HDV is one of the many forms of hepatitis. Other types:
- Hepatitis A, which is transmitted through direct contact with faeces or indirect faecal contamination of food or water.
- Hepatitis B, which is transmitted through exposure to bodily fluids such as blood, urine, and semen.
- Hepatitis C, which is spread by contact with contaminated blood or needles
- Hepatitis E, which is a short-term, self-resolving version of hepatitis that is transmitted through indirect faecal contamination of food or water.
- Unlike other forms, hepatitis D is not contracted on its own. It only infects people who are already infected with hepatitis B.
Hepatitis D can be acute or chronic. Acute hepatitis D occurs suddenly and usually causes more severe symptoms. It can go away on its own. If the infection persists for six months or more, the condition is called chronic hepatitis D. The chronic version of the infection develops gradually over time. The virus can remain in the body for many months before symptoms appear. As chronic hepatitis D progresses, the chances of complications increase. Most people with this condition eventually develop cirrhosis or severe scarring of the liver.
There is currently no treatment or vaccine for hepatitis D, but it can be prevented in those who are not yet infected with hepatitis B. Treatment can also help prevent liver failure when the condition is caught early.
What are the symptoms of hepatitis D?
Hepatitis D is not always a reliable source of symptoms. When symptoms do occur, they often include:
- Yellowing of the skin and eyes, called jaundice.
- Joint pain
- Abdominal pain
- Lack of appetite
- Dark urine
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, it can make hepatitis B symptoms worse. It can cause symptoms in people with hepatitis B, but never.
Can you have hepatitis D with other types of hepatitis?
People can get hepatitis D if they have hepatitis B. About 5% of people with hepatitis B are also infected with hepatitis D. People can get the hepatitis B vaccine to protect themselves from both hepatitis B and D.
Other types of hepatitis have different causes, so it is possible for a person to have other types. People can get hepatitis A or E through contaminated food or water, but they can also get hepatitis C through direct contact with infected blood.
How do you get hepatitis D?
Hepatitis D is caused by HDV. The infection is spread through direct contact with the infection and the body fluids of the infected person. It can be transmitted through:
- Vaginal fluids
- Birth (from mother to newborn)
Once you have hepatitis D, you can infect other people before your symptoms appear. However, you can only get hepatitis D if you already have hepatitis B. About 5 per cent of people with hepatitis B develop hepatitis D, according to the Children’s Hospital of Philadelphia. Hepatitis D develops when you contract it. Hepatitis B.
Causes and risk factors of hepatitis D
People contract hepatitis D from contact with the virus in the body fluids of infected people. However, hepatitis D can only be acquired if a person already has hepatitis B, because HDV is used to replicate the hepatitis B virus.
Conditions in which a person comes into contact with the body fluids of an infected person:
- Sharing needles
- Having unprotected sex
- Involves blood-to-blood contact
- During the delivery
- Use of medical equipment or medical equipment that is not clean
People cannot become infected with the virus from the following activities or types of contact:
- Coughing or sneezing
- Sitting next to each other
- Shake or hold hands
- Sharing eating utensils
- You also can’t get this disease from food or drink.
People at high risk for hepatitis D include:
- Have hepatitis b
- Did not receive the hepatitis B vaccine
- Inject medications
- Having unprotected sex with multiple partners.
- You live in a part of the world where this infection is high
- A person who has sex with other men.
- Often receives a blood transfusion
- Use injectable or intravenous (IV) medications such as heroin
How is hepatitis D diagnosed?
Call your doctor right away if you have symptoms of this disease. 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 have been exposed to the virus.
Your doctor will also do a liver function test if they suspect you have liver damage. It is a blood test that measures the health of your liver by measuring the levels of proteins, liver enzymes, and bilirubin in your blood. Results of liver function tests show whether your liver is stressed or damaged.
Treatment of hepatitis D
If you have HDV, you should see a doctor who works with diseases of the digestive system, including the liver, such as a gastroenterologist. Doctors called hepatologists are more specialized and only treat liver disease.
- HDV is not yet covered. Until doctors present better options, the most commonly prescribed drug is pegylated interferon-alpha (PEG-IFN).
- Peg-ifn doesn’t work well for everyone. It can also cause many side effects such as lack of energy, weight loss, flu-like symptoms, and mental health problems like depression.
- Doctors are not sure how long HDV treatment will last. You have to take peg-ifn during the year. If a blood test shows a certain amount of virus in your body, your doctor may recommend that you continue taking PEG-IFNa for another year.
How well does the treatment work?
How you respond to HDV treatment depends on how sick you are with the virus. Peg-Ifn can often remove HD from most people with coinfection. If you have a superinfection, you are less likely to get the virus. You need to learn to handle HDV and HBV as life-long conditions.
Other types of HDV treatment are being tested. These include drugs that prevent the virus from attacking or blocking the hepatitis B cells in which they live. If you have advanced liver disease, your doctor may recommend a liver transplant.
Prevention of hepatitis D
No vaccine can prevent HDV. The best way to prevent this is to reduce the risk of hepatitis B. Talk to your doctor about the HBV vaccine. Avoid contact with blood or other body fluids in people with hepatitis.
- Don’t share needles if you are taking medicine.
If you already have hepatitis B, you can lower your risk of HDV. This means:
- Keep personal items such as toothbrush and razor separate.
- Wear gloves if you need to touch someone else’s throat or open the wound.
- If you have HDV, make healthy choices every day to protect your liver from further damage.
- Avoid alcohol and talk to your doctor about ways to eat right. You want to be careful not to infect others.
- Inform your doctor and dentist of your diagnosis before each visit.
- If you donate tissue, organs, blood, semen, or other body fluids, it is not safe for others.
Complications of hepatitis D
A person with chronic hepatitis D infection may experience chronic itching and unexplained weight loss. Acute hepatitis D infections damage the liver and can sometimes cause severe liver failure, although this is very rare.
Chronic hepatitis D infections can cause:
- Cirrhosis, which is a scar of the liver.
- For liver failure
- Liver cancer
Symptoms of these problems include:
- Bleeding or bruising easily
- Swelling of the legs or ankles due to water retention.
- Yellowing of the skin or eyes
- Severe itching
- Unexplained weight loss
Treatment for the problems involves taking antiviral medications, which work to prevent the virus from further damaging the liver. Avoiding alcohol and maintaining a healthy lifestyle can also help limit your risk.
If chronic hepatitis D causes liver cancer, treatment may include:
- Radiation therapy to kill cancer cells.
- Surgery to remove the cancerous part of the liver.
- Immunotherapy helps the immune system fight cancer cells.
- Liver transplant
- Early diagnosis of liver cancer increases the likelihood of successful treatment.
- If people have liver failure, it means that the liver is not working properly and they need a liver transplant.
- Early treatment of hepatitis D and B can help reduce the risk of complications from infections.