Hepatitis D (patient information)

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Hepatitis D


What are the symptoms?

What are the causes?

Who is at highest risk?

When to seek urgent medical care?


Treatment options

Where to find medical care for Hepatitis D?

What to expect (Outlook/Prognosis)?

Possible complications


Hepatitis D On the Web

Ongoing Trials at Clinical Trials.gov

Images of Hepatitis D

Videos on Hepatitis D

FDA on Hepatitis D

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Directions to Hospitals Treating Hepatitis D

Risk calculators and risk factors for Hepatitis D

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]


Also known as "delta hepatitis," is a serious liver disease caused by infection with the Hepatitis D virus (HDV), which is an RNA virus structurally unrelated to the Hepatitis A, B, or C viruses. Hepatitis D, which can be acute or chronic, is uncommon in the United States. HDV is an incomplete virus that requires the helper function of Hepatitis B virus to replicate and only occurs among people who are infected with the Hepatitis B virus (HBV). Common symptoms include: abdominal pain, nausea, vomiting, jaundice and loss of appetite. HDV is transmitted through percutaneous or mucosal contact with infectious blood and can be acquired either as a coinfection with HBV or as superinfection in persons with HBV infection. There is no vaccine for Hepatitis D, but it can be prevented in persons who are not already HBV-infected by Hepatitis B vaccination. Possible complications include: severe acute and chronic hepatitis, cirrhosis and hepatocellular carcinoma.

What are the symptoms of Hepatitis D?

Hepatitis D may make the symptoms of hepatitis B more severe. Symptoms may include:

Exams and Tests

What causes Hepatitis D?

Hepatitis D or delta hepatitis is caused by the hepatitis delta virus (HDV), a defective RNA virus. HDV requires the help of a virus like the hepatitis B virus (HBV) for its own replication. Hepatitis D virus (HDV) is only found in people who carry the hepatitis B virus. HDV may make a recent (acute) hepatitis B infection or an existing long-term (chronic) hepatitis B liver disease worse. It can even cause symptoms in people who carry hepatitis B virus but who never had symptoms. Hepatitis D occurs in 5% of people who carry hepatitis B.

Risk factors include:

  • Using intravenous (IV) or injection drugs
  • Being infected while pregnant (the mother can pass the virus to the baby)
  • Carrying the hepatitis B virus
  • Men having sexual intercourse with other men
  • Receiving many blood transfusions


Transmission is similar to that of HBV:

  • Bloodborne and sexual
  • Percutaneous (injecting drug use, haemophiliacs)
  • Permucosal (sexual)
  • Rare perinatal

HDV is transmitted percutaneously or sexually through contact with infected blood or blood products.

Blood is potentially infectious during all phases of active hepatitis D infection. Peak infectivity probably occurs just before the onset of acute disease.

Who is at highest risk?

Risk factors include:

Since HDV absolutely requires the support of hepatitis B virus for its own replication, inoculation with HDV in the absence of HBV will not cause hepatitis D. Alone, the viral genome indeed replicates in a helper-independent manner, but virus particles are not released

Individuals who are not infected with HBV, and have not been immunized against HBV, are at risk of infection with HBV with simultaneous or subsequent infection with HDV.

When to seek urgent medical care?

Call for an appointment with your health care provider if you have symptoms of hepatitis B.


The diagnosis of acute hepatitis D is made after evaluation of serologic tests for the virus. Total anti-HDV are detected by commercially available radioimmunoassay (RIA) or enzyme immunoassay (EIA) kits.

The method of choice for the diagnosis of ongoing HDV infection should be RT-PCR.

Other tests that help in the diagnosis of hepatitis D include:

Treatment options

Currently there is no treatment for hepatitis D.

Disease conditions may occasionally improve with administration of a-interferon (a vaccine administrated during 12 months)

Since no effective antiviral therapy is currently available for treatment of type D hepatitis, liver transplantation may be considered for cases of fulminant acute and end-stage chronic hepatitis D.

A liver transplant for end-stage chronic hepatitis B may be effective.

Where to find medical care for Hepatitis D?

Directions to Hospitals Treating Hepatitis D

What to expect (Outlook/Prognosis)?

Persons with an acute HDV infection usually get better over 2 to 3 weeks.

Liver enzyme levels return to normal within 16 weeks.

About 10% of those who are infected may develop long-term (chronic) liver inflammation (hepatitis).

Possible complications

Possible complications of hepatitis D include:


Since HDV is dependent on HBV for replication, control of HDV infection is achieved by targeting HBV infections. All measures aimed at preventing the transmission of HBV will prevent the transmission of hepatitis D.

No vaccines exist against HDV; however, vaccination against HBV of patients who are not chronic HBV carriers, provides protection against HDV infection.

However, there is no effective measure to prevent HDV infection of chronic HBV carriers, and prevention of HBV-HDV superinfection can only be achieved through education to reduce risk behaviors.

Prompt diagnosis and treatment of hepatitis B infection can help prevent hepatitis D.

Avoidance of intravenous drug abuse. If you use IV drugs, avoid sharing needles.

Alternative Names

Hepatitis D virus


World Health Organization