Hepatitis D (Delta agent)
Delta agentHepatitis D is a viral infection caused by the hepatitis D virus (previously called the Delta agent). It causes symptoms only in people who also have hepatitis B infection.
Hepatitis B
Hepatitis B is irritation and swelling (inflammation) of the liver due to infection with the hepatitis B virus (HBV). Other types of viral hepatitis ...
Causes
Hepatitis D virus (HDV) is found only in people who carry the hepatitis B virus. It can occur with a new infection of hepatitis B (coinfection) or on top of a hepatitis B infection (superinfection). HDV may make liver disease worse in people who have either recent (acute) or long-term (chronic) hepatitis B. It can even cause symptoms in people who carry hepatitis B virus, but who never had symptoms.
Hepatitis B
The term "liver disease" applies to many conditions that stop the liver from working or prevent it from functioning well. Abdominal pain or swelling...
Hepatitis D infects about 15 million people worldwide. It occurs in a small number of people who carry hepatitis B.
Risk factors include:
- Being infected while pregnant (the mother can pass the virus to the baby).
- Carrying the hepatitis B virus.
- Being in a high-risk group for getting hepatitis B or D. Examples include sharing body fluids such as through sexual contact, household blood or saliva contact, or sharing needles/drug equipment.
- Receiving many blood transfusions. The US blood supply is screened for hepatitis virus, so this is uncommon.
- Using intravenous (IV) or injection drugs.
- Rarely, a baby can get hepatitis D from a mother with hepatitis D.
Symptoms
Hepatitis D may make the symptoms of hepatitis B worse.
Symptoms may include:
- Abdominal pain
- Dark-colored urine
- Fatigue
- Jaundice
- Joint pain
- Loss of appetite
- Nausea
- Vomiting
Exams and Tests
You may need the following tests:
- Anti-hepatitis D antibody. Blood tests for hepatitis B will also be done.
Anti-hepatitis D antibody
The hepatitis virus panel is a series of blood tests used to detect current or past infection by hepatitis A, hepatitis B, or hepatitis C. It can sc...
ImageRead Article Now Book Mark Article - Liver biopsy is occasionally done.
Liver biopsy
A liver biopsy is a test that takes a sample of tissue from the liver for examination.
ImageRead Article Now Book Mark Article - Liver enzymes (blood test) and other bloodwork to check for other liver diseases and see how damaged the liver is.
Liver enzymes
Liver function tests are common tests that are used to see how well the liver is working. Tests include:AlbuminAlpha-1 antitrypsinAlkaline phosphata...
ImageRead Article Now Book Mark Article - Imaging tests such as an abdominal ultrasound or a special ultrasound called elastography, to look at the liver and see how damaged it is.
- Evaluation for liver cancer.
Treatment
Many of the medicines used to treat hepatitis B are not helpful for treating hepatitis D.
You may receive a once weekly injectable medicine called pegylated alpha interferon for up to 12 months if you have a long-term HDV infection. A liver transplant for end-stage chronic hepatitis B may be effective.
Outlook (Prognosis)
People with an acute HDV infection most often get better over 2 to 3 weeks. Liver enzyme levels return to normal within 16 weeks.
Acute
Acute means sudden. Acute symptoms appear, change, or worsen rapidly. It is the opposite of chronic.
About 1 in 10 of those who are infected may develop long-term (chronic) liver inflammation (hepatitis).
Possible Complications
Complications may include:
- Chronic active hepatitis
- Acute liver failure
When to Contact a Medical Professional
Contact your health care provider if you have symptoms of hepatitis D.
Prevention
Steps to prevent the condition include:
- Detect and treat hepatitis B infection as soon as possible to help prevent hepatitis D.
- Avoid intravenous (IV) or injection drug use. If you inject drugs, avoid sharing needles.
- Get vaccinated against hepatitis B.
Adults who are at high risk for hepatitis B infection and all children should get this vaccine. If you do not get Hepatitis B, you cannot get Hepatitis D.
References
Ghany MG. Hepatitis D. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 81.
Murray PR, Rosenthal KS, Pfaller MA. Hepatitis viruses. In: Murray PR, Rosenthal KS, Pfaller MA, eds. Medical Microbiology. 9th ed. Philadelphia, PA: Elsevier; 2021:chap 55.
Thio CL, Hawkins C. Hepatitis delta virus. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 146.
Hepatitis B virus - illustration
Hepatitis B is also known as serum hepatitis and is spread through blood and sexual contact. It is seen with increased frequency among intravenous drug users who share needles and among the homosexual population. This photograph is an electronmicroscopic image of hepatitis B virus particles. (Image courtesy of the Centers for Disease Control and Prevention.)
Hepatitis B virus
illustration
Hepatitis B virus - illustration
Hepatitis B is also known as serum hepatitis and is spread through blood and sexual contact. It is seen with increased frequency among intravenous drug users who share needles and among the homosexual population. This photograph is an electronmicroscopic image of hepatitis B virus particles. (Image courtesy of the Centers for Disease Control and Prevention.)
Hepatitis B virus
illustration
Review Date: 10/30/2024
Reviewed By: Jenifer K. Lehrer, MD, Gastroenterologist, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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