What Is Hepatitis D?

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Delta hepatitis or hepatitis D virus (HDV) is a viral infection of the liver. You can get hepatitis D only once you’ve already been infected with the hepatitis B virus (HBV).

Hepatitis D is transmitted from other infected individuals. Some people experience mild, short-term symptoms, while others face serious effects that may be fatal.

Being aware of the current global hotspots can help you stay informed while traveling. Geographical locations most impacted by hepatitis D include the Republic of Moldova, Mongolia, and countries in Central and Western Africa. Hepatitis D is also more common in the Mediterranean, the Middle East, and South America’s Amazon basin.

Since there is no available treatment for hepatitis D, prevention is crucial. Here’s what you should know about protecting yourself from a hepatitis D infection and what to do if you are exposed.

Healthcare worker administering a vaccination

Catherine McQueen / Getty Images

Types of Hepatitis D

The term hepatitis means liver inflammation. Although viral infections are the primary cause of hepatitis, autoimmune diseases and exposure to toxins can also cause liver inflammation.

For humans, the five different types of viral hepatitis of concern are A, B, C, D, and E. Each of these variants is associated with a specific virus.

Within the umbrella of hepatitis D viruses, there are eight unique genotypes that contain between two to four subtypes each. The different HDV genotypes are geographically distributed as follows:

  • Genotype 1: Europe and North America (most common type)
  • Genotype 2: Asia and Middle East
  • Genotype 3: Amazon basin
  • Genotype 4: China, Japan, and Taiwan
  • Genotype 5–8: Africa and some European regions

Hepatitis D Symptoms

Symptoms of acute hepatitis are similar among all types and usually occur between three to seven weeks after infection. These can include:

Acute Liver Failure

Becoming infected with hepatitis B and D simultaneously (called a co-infection) usually produces more severe symptoms, including acute liver failure in some individuals.

Acute liver failure is an emergency that requires immediate medical attention. Symptoms may include sleepiness, confusion, bruising/bleeding, belly distention, and diarrhea.

Causes

HDV is caused by a virus that’s spread through contact with infected bodily fluids or exposure through skin puncture.

The risk of exposure is highest in these groups:

  • Babies born to infected mothers
  • Children born in high HBV regions
  • Healthcare workers
  • People with hemophilia
  • Hemodialysis patients
  • Intravenous drug users
  • Men who have sex with men
  • People who have multiple sex partners or sexually transmitted infections
  • Public safety workers
  • People sharing a household with someone who has chronic hepatitis
  • People who have sexual contact with someone who has HDV

If you’re in a high-risk group, particularly if you run the risk of exposure to infected needles, a hepatitis B vaccine can protect against HDV. Practicing safe sex, seeking prenatal care when pregnant, and avoiding unsafe tattoos and piercings can help prevent getting or spreading HDV.

Diagnosis

Blood tests are used to diagnose HDV. Only after an individual is confirmed for HBV—either through a positive blood test for the antigen HBsAg or HBV DNA—should they be considered for hepatitis D testing. Your doctor will likely ask you about potential exposures, screen for high-risk behaviors, and check for physical signs of hepatitis.

Hepatitis D can be detected by checking for antibodies through a blood test. Sometimes people test positive for antibodies even though they’ve already recovered from HDV.

The presence of HDV antigens or HDV DNA in the blood would confirm a present infection, but this type of testing is only available in research labs, not for typical patient use.

Treatment

Unfortunately, there are no FDA-approved treatments for HDV. If diagnosed, your provider should offer ongoing monitoring of your liver to screen for signs of cirrhosis (scarring of the liver) and liver cancer.

Interferon treatments are often provided to help boost the body’s natural antiviral response, but they have limited effectiveness. For now, symptom management and efforts to prevent other diseases through screening, lifestyle interventions, and vaccination is the usual course of action when HDV is detected.

Prognosis

Usually, hepatitis D goes away on its own when the immune system fights off the infection. However, in less than 5% of cases, hepatitis D becomes a chronic infection with lasting health effects. If someone already has HIV or hepatitis C, they may have a harder time recovering from HDV.

Symptoms for an HDV co-infection with HBV typically last about 90 days. A superinfection—defined as catching HDV while already having an underlying chronic hepatitis B infection—usually causes symptoms for two to eight weeks.

Most of the time, co-infections end up with the immune system eliminating both viruses from the body. However, superinfections are associated with the development of cirrhosis and liver cancer within a few decades.

Summary

Hepatitis D is a form of viral hepatitis that only occurs in people who have hepatitis B. It causes common hepatitis symptoms such as abdominal pain and jaundice. It is spread through blood and body fluids. Hepatitis D is treated with symptom management. It usually resolves on its own, but in some cases, it may become chronic.

A Word From Verywell

The troubling symptoms of hepatitis can serve as an incentive to avoid risky behaviors like intravenous drug use and unprotected sex. However, it’s not always possible to prevent accidents from happening, such as an unexpected needle stick.

Taking care to protect yourself through vaccinations and a healthy lifestyle are the best defenses against hepatitis and other diseases.

Frequently Asked Questions

How are hepatitis B and D related?

Hepatitis D is known as a satellite virus, or incomplete virus, because of a DNA defect that renders it unable to replicate on its own. HDV relies on the presence of HBV in order to survive. This can either be a co-infection (infection occurs at the same time) or superinfection (infection in someone who has chronic underlying HBV).

While someone can get HBV without HDV, it’s impossible for the opposite to occur.

Hepatitis B and D are similar because they produce similar symptoms, are caused by viruses that inflame the liver, and can be transmitted through bodily fluids or blood. The main difference between HBV and HDV is viral structure. HBV is a double-stranded DNA virus, and HDV is an RNA virus.

How is hepatitis D transmitted?

Hepatitis D can be transmitted from mother to child during childbirth. However, it is unlikely to be transmitted while the baby is still in utero.

Infected blood or other bodily fluids (through sexual contact) can transmit HDV. Exposure also occurs from infected needles, either through needle-sharing or accidental needle sticks.

Is there a vaccine for hepatitis D?

There is no vaccine for hepatitis D directly, but since an infection of hepatitis B is required before a hepatitis D infection can occur, hepatitis B vaccines are one way to prevent HDV. However, if someone already has chronic hepatitis B, there is no effective vaccine to prevent them from contracting HDV.

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9 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. Centers for Disease Control and Prevention. Hepatitis D questions and answers for health professionals. Updated March 9, 2020.

  2. World Health Organization. Hepatitis D.

  3. World Health Organization. Hepatitis.

  4. National Organization for Rare Disorders. Hepatitis D.

  5. Cedars Sinai. Acute liver failure.

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

  7. Cleveland Clinic. Hepatitis D: diagnosis.

  8. Negro F. Hepatitis D virus coinfection and superinfection. Cold Spring Harb Perspect Med. 2014;4(11):a021550. doi:10.1101/cshperspect.a021550

  9. Centers for Disease Control and Prevention. Hepatitis D. Updated June 22, 2020.