Hepatitis D infection is caused by the hepatitis D virus (HDV). When this virus enters the body, it goes to the liver and causes inflammation there. Hepatitis D is also known as “delta hepatitis” and occurs only in people who already have hepatitis B. This is because hepatitis D virus (HDV) is a virus that requires hepatitis B virus (HBV) for its replication. So the only way you can have hepatitis D is as a co-infection or super-infection with hepatitis B.
According to WHO estimation, a total of 15 – 20 million persons are infected with HDV worldwide (which is 5% of people infected with hepatitis B). You can get infected with Hepatitis D virus when you come in contact with infected body fluids (blood, urine, semen and vaginal fluid). Although it is possible, mother-to-child transmission of the virus is rare.
An infected person can either develop an acute infection (short term) or chronic infection (long term). Whiles acute infection with hepatitis D virus doesn’t pose much threat to the liver, chronic infections can lead to serious liver damage like fibrosis, cirrhosis and liver cancer. Treatment may help prevent liver failure when hepatitis D is detected early.
Reports from WHO says that co-infection with hepatitis B is considered the most severe form of chronic viral hepatitis due to more rapid progression towards liver-related death and hepatocellular carcinoma. There is no vaccine for hepatitis D, but it can be prevented in people who are not already HBV-infected by hepatitis B vaccination.
Those most at risk of getting infected with hepatitis virus include the following :
- Those who already have hepatitis B infection.
- Having multiple sexual partners.
- Men who have sex with other men.
- Those who are to receive blood transfusions.
- People who inject drugs, such as heroin.
- Being born to a mother who has hepatitis D.
The symptoms of hepatitis D are similar to those of hepatitis B. Even though it is possible to have hepatitis D without showing any noticeable symptoms, infected people usually complain of :
- Loss of appetite.
- Nausea and vomiting.
- Abdominal pain (especially in the right upper abdomen).
- Yellow skin and eyes (jaundice).
- Dark urine.
- Pale faeces.
- Muscle and joint pain.
If you or your child have any of these symptoms ensure that you see your doctor in good time. This is especially if you already have been diagnosed with hepatitis B.
Diagnosis and Treatment
In order to properly diagnose hepatitis D infection, your doctor will ask you a couple of questions to determine whether you may have been recently exposed to the virus. He will also examine your body to see whether he can pick up any signs of the infection or possible liver damage. Confirmatory diagnosis however, requires laboratory screening of your blood for the hepatitis D virus.
An anti-HDV test which shows high titres of immunoglobulin G (IgG) and immunoglobulin M (IgM) indicates that you have been previously exposed to the hepatitis D virus. A separate test called HDV RNA assay is used to confirm current infection with the virus. In some cases, doctors can use HBsAg test and liver function test to monitor how you are responding to treatment and the progression of the disease.
Antiviral drugs are available to treat hepatitis D infection but they don’t seem to be very effective. Surgery for liver transplant may become necessary when liver failure starts setting in.
The best prevention against hepatitis D is to get vaccinated with hepatitis B vaccine. Hepatitis B vaccination is recommended for infants and those at a higher risk of acquiring hepatitis B infection.
Other things you can do to prevent hepatitis D infection include :
- Practicing safe sex.
- Stop injecting illicit drugs or avoid sharing syringes if you can’t.
- Use protective equipment when dealing with blood samples or infected patients at the hospital.
- WHO – hepatitis D fact sheet
- CDC – hepatitis D
- SA Health – hepatitis D symtoms, treatment and prevention