Causes and Risk Factors of Hepatitis D

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Hepatitis D is a virus that affects the liver. There’s no vaccine or specific treatment for hepatitis D. You can’t get a hepatitis D infection unless you already have a hepatitis B infection or are infected with both viruses at the same time. 

You can have an acute (short-term) or chronic (long-term) case of hepatitis D. Chronic infection happens when the body can't fight off the active infection. You’re more likely to develop complications if you develop chronic hepatitis. There is no cure for this viral infection, so prevention is crucial. 

This article will look at the common causes and risk factors of hepatitis D. 

Hepatitis is spread through recreational injection drug use and sharing needles

vladans / Getty Images

Common Causes 

You can only get hepatitis D if you have a hepatitis B infection or you become infected with both at the same time. That’s because the hepatitis D virus needs the help of hepatitis B virus particles to cause an infection. 

Hepatitis D spreads via:

  • Blood
  • Sexual contact

You can get hepatitis D infection if you already have a hepatitis B infection. When you have both hepatitis B and D, your symptoms will likely be more severe than with hepatitis B alone. When you contract both at the same time, this is called a coinfection.

Superinfection is when you already have chronic hepatitis B and then contract hepatitis D. If you have hepatitis B and don’t have any symptoms, contracting hepatitis D may cause you to experience symptoms.

Most people who contract both viruses display symptoms. And most people who have a superinfection go on to develop chronic hepatitis D in addition to their chronic hepatitis B.

People with both hepatitis B and D also have a worse prognosis (projected outcome) overall than those who just have hepatitis B.

Symptoms of Hepatitis D

Symptoms of active hepatitis infection include:

  • Jaundice (yellowing of the skin and whites of the eyes)
  • Abdominal pain
  • Joint pain
  • Appetite loss
  • Fatigue
  • Dark-colored urine
  • Nausea and vomiting 

Lifestyle Risk Factors

You can only contract hepatitis D if you’ve already been infected with the hepatitis B virus or both viruses infect you at the same time.

You’re at higher risk of contracting the viruses if you:

  • Inject recreational drugs intravenously
  • Live somewhere where hepatitis B infections are common 
  • Live in a household with someone who has chronic hepatitis
  • Have multiple sexual partners
  • Have had sexual contact with someone who has hepatitis D
  • Work in health care or a related field
  • Are on dialysis (treatment using machines to perform duties of the kidneys, namely filtering waste and excess fluid from the blood)
  • Are a man who has sex with men
  • Receive many blood transfusions or blood products

Additionally, babies born to a parent with hepatitis D are more likely to contract the disease. It's rare for the disease to get passed from parent to child during birth, but it does happen.

Preventing Hepatitis D

Prevention for hepatitis D involves strategies to also prevent hepatitis B. Since hepatitis D doesn’t cause an active infection unless a person has hepatitis B or acquires it at the same time, getting vaccinated against hepatitis B is one way to avoid a serious hepatitis D infection.

If a person already has hepatitis B, they should try to avoid potential risk factors for hepatitis D, many of which are the same as those for hepatitis B.
Ways to avoid a hepatitis B infection include:

  • Wear condoms to protect against sexually transmitted infections (STIs).
  • Avoid injecting recreational drugs and sharing needles with others.
  • Avoid sharing personal care items like razors with other people.
  • Do your research and check references for artists and piercers before getting a tattoo or piercing.
  • Get the hepatitis B vaccine.


Hepatitis D is a viral infection that can only occur when someone already has a hepatitis B infection or if they become infected with both viruses at the same time. Hepatitis D risk factors are like those for hepatitis B since both viruses spread through blood and sexual contact. There’s no cure for hepatitis D.

A Word From Verywell 

If you think you’ve been exposed to hepatitis B or D, it’s essential to get tested to avoid complications since 1 in 10 people with hepatitis D go on to develop long-term liver inflammation. Getting prompt treatment for hepatitis B can help prevent an infection with hepatitis D. 

A healthcare provider can order blood tests to check whether you have an active infection and provide guidance on how to proceed. While hepatitis D is incurable, there are ways to manage symptoms

Because hepatitis D can cause liver damage and potentially liver failure, it’s vital that a healthcare provider monitor your health if you have an active infection. 

5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. National Institute of Diabetes and Digestive and Kidney Diseases. Hepatitis D

  2. Pan American Health Organization. Hepatitis D

  3. MedlinePlus. Hepatitis D.

  4. Iowa Department of Public Health. Hepatitis D.

  5. Minnesota Department of Health. Hepatitis D infection fact sheet.

By Steph Coelho
Steph Coelho is a freelance health writer, web producer, and editor based in Montreal. She specializes in covering general wellness and chronic illness.