How Hepatitits D Is Treated

There are several different types of hepatitis, but hepatitis D is considered the most severe. Hepatitis D is transmitted through bodily fluids, especially blood. You must be infected with hepatitis B in order to contract hepatitis D.

Despite medical advances, treatment options remain limited. Protecting yourself from contracting the virus in the first place is crucial. If you test positive for hepatitis D, medication or surgery could help reduce further complications.

This article details the next steps your doctor may recommend for treating hepatitis D, including lifestyle, over-the-counter medications, prescriptions, surgery, and complementary and alternative treatments.

Doctor sitting down and speaking with couple

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Home Remedies and Lifestyle

Healthcare and sanitation workers who have a higher chance of exposure to needle pricks should take additional precautions to prevent the accidental spread of infection. If you use injection drugs or live with someone who does, seek help immediately to reduce your exposure to long-term consequences.

Getting a hepatitis B vaccination can protect you against contracting hepatitis D, so talk to your doctor if you believe you’re at risk.

Abstaining from alcohol will minimize strain on your liver. If you choose to drink, it’s essential to drink responsibly. Health authorities define responsible drinking as no more than one drink per day for women and no more than two drinks per day for men.

Binge drinking is harmful, especially when your liver function is already compromised from hepatitis.

Following safe sex practices will keep you from contracting additional infections and help keep your partner from getting hepatitis D. Safe sex to prevent the spread of hepatitis D is particularly important for men who have sex with other men.

Over-the-Counter Therapies

Your doctor may suggest over-the-counter products to help manage the symptoms of hepatitis D, but you should never take anything without your healthcare professional’s permission. Many medications contain ingredients that can are tough for the liver to process, such as Tylenol (acetaminophen) and nonsteroidal anti-inflammatory drugs (NSAIDs), including aspirin.

Prescriptions

Pegylated interferon-alpha has been prescribed to treat hepatitis D for decades, however its effectiveness remains limited to about 25% of cases or less. Scientists have experimented with longer durations of the drug or combining it with other therapies, including ribavirin, lamivudine, or adefovir, with underwhelming success rates.

Current recommendations advise the administration of pegylated interferon-alpha for 48 weeks unless contraindicated by an autoimmune disease, active psychiatric condition, or decompensated cirrhosis. Unlike other types of hepatitis that may be blocked by viral inhibitors, hepatitis D is harder to target.

Therapy with interferon-alpha is monitored by blood tests, including a complete blood count, serum alanine aminotransferase (ALT), serum hepatitis D virus RNA, and hepatitis B surface antigen (HBsAg). This helps identify whether you are responding to the treatment or need a longer course of treatment. 

Since hepatitis B is required for hepatitis D to successfully infect its host, research is looking at drugs that interfere with hepatitis B antigens in an effort to slow down or prohibit hepatitis D replication.

These medications include Myrcludex B, lonafarnib, and REP 2139. Depending on clinical trial results, it’s possible that they’ll be used along with other hepatitis D therapies in the future.

Surgeries and Specialist-Driven Procedures

There are no procedures to cure hepatitis. However, sometimes individuals with a severe (fulminant) case of hepatitis D or end-stage liver disease may be given a lifesaving liver transplant.

To give your body the best chance of a successful transplant, you’ll want to maintain healthy habits, including good nutrition, regular physical activity, and the avoidance of harmful substances—like alcohol, drugs, and cigarettes.

Complementary and Alternative Medicine

Several supplements are marketed to promote liver health or even repair a damaged liver, but you should never rely on them to treat hepatitis D. Common ingredients in these products include milk thistle or turmeric, which may have some potential for liver health but fall short of any proven benefits for hepatitis.

Furthermore, since dietary supplements are not regulated by the Food and Drug Administration, it’s impossible to know if what you’re buying actually contains the ingredients written on the label. Several herbal supplements and vitamins are known to be toxic to the liver, so it’s best not to take your chances with a potentially harmful product.

Discuss any herb or supplement you are thinking of taking with your healthcare professional so they can advise you on whether it may be harmful to your condition.

Summary

Hepatitis D currently has only one treatment, pegylated interferon-alpha, although research continues for additional treatment. Avoiding alcohol and other substances, medications, and supplements toxic to the liver may help prevent liver damage. A liver transplant may be needed if damage is severe.

A Word From Verywell

Unfortunately, there are limitations in what scientists currently understand about hepatitis D, and current treatments with pegylated interferon-alpha only go so far. While newer medications seem promising, there may be significant side effects to keep in mind.

Maintaining regular back-and-forth communication with your healthcare professional will help you stay on top of the necessary health screenings and the latest treatment options available for hepatitis D.

Frequently Asked Questions

Are there medications for hepatitis D?

There is no available cure for hepatitis D. The best medication currently available is pegylated interferon-alpha. It’s typically prescribed for 48 months and has limited effectiveness.

What complications can hepatitis D cause?

Symptoms of hepatitis D may include:

  • Dark urine
  • Fatigue
  • Jaundice
  • Pain in the upper abdomen
  • Nausea
  • Swelling in the abdomen or legs
  • Vomiting
  • Weight loss

If your immune system is unable to fight off hepatitis D, longer-term complications like liver failure from cirrhosis (scarring) or liver cancer may occur.

What can you do to prevent hepatitis D?

One of the best ways to prevent hepatitis D is by getting a hepatitis B vaccination. Since it’s impossible to contract hepatitis D without hepatitis B, avoiding hepatitis B in the first place is the best-case scenario.

If you already have hepatitis B, you can still prevent hepatitis D by abstaining from risky behaviors, such as unprotected sex and injection drug use. If you need help to develop safer habits, talk to your healthcare professional for a referral to a social worker, therapist, or treatment program.

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7 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. Farci P, Niro GA. Current and future management of chronic hepatitis D. Gastroenterol Hepatol (N Y). 2018;14(6):342-351.

  2. National Institute of Diabetes and Digestive and Kidney Diseases. Hepatitis D. Updated May 2017.

  3. Department of Veteran’s Affairs. Viral hepatitis and liver disease. Updated August 27, 2019.

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

  5. Johns Hopkins Medicine. Drug-induced hepatitis.

  6. World Health Organization. Hepatitis D.

  7. Johns Hopkins Medicine. Detoxing your liver: fact versus fiction.