Hepatitis D prevention

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2] Jolanta Marszalek, M.D. [3]

Overview

HDV infection requires the person to be co-infected with HBV, therefore, vaccination against hepatitis B confers immunity against hepatitis D. Since a vaccine against hepatitis D, for patients infected with HBV, is not available, these individuals should prevent superinfection by avoiding risk behaviors, such as: contact with blood from infected individuals, and sharing of sharp objects.

Prevention

In order to be infected with hepatitis D, a patient must be previously infected with HBV (superinfection) or be infected by HBV at the same moment of infection with HDV (coinfection). The best prevention against hepatitis D is vaccination with hepatitis B vaccine.[1]

Since a vaccine against hepatitis D is not available for patients who are already infected with HBV, the best course of action to prevent superinfection in these patients is to avoid risk behaviors, such as: [1]

  • Sex with an infected partner
  • Contact with the blood of an infected person
  • Sharing of needles, syringes, razors, or toothbrushes with an infected person
  • Healthcare workers who deal with sharp objects, potentially with blood from infected patients should take extra caution

It is essential to vaccinate family members of patients who are infected with HBV and HDV. Despite the common parenteral transmission of HDV, the virus has been noted to be transmitted among family members, which justifies extraordinary precautions in these families.[2]

HIV Infected Patients

HIV infected persons may not develop protective immunity after receiving the hepatitis B vaccine. Hence, they remain at risk for infection with HBV and HDV.[3]

Pregnant Patients

Pregnant women should be screened for hepatitis B infection. If a woman is at risk for HBV infection, she should be vaccinated. The current recommendations of the American College of Pediatrics and the Centers for Disease Control and Prevention are that all infants be immunized against hepatitis B.[4]

References

  1. 1.0 1.1 "Hepatitis D prevention".
  2. Niro GA, Casey JL, Gravinese E, Garrubba M, Conoscitore P, Sagnelli E; et al. (1999). "Intrafamilial transmission of hepatitis delta virus: molecular evidence". J Hepatol. 30 (4): 564–9. PMID 10207796.
  3. Center for Substance Abuse Treatment. Screening for Infectious Diseases Among Substance Abusers. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 1993. (Treatment Improvement Protocol (TIP) Series, No. 6.) Chapter 15 - Viral Hepatitis D.
  4. Center for Substance Abuse Treatment. Screening for Infectious Diseases Among Substance Abusers. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 1993. (Treatment Improvement Protocol (TIP) Series, No. 6.) Chapter 15 - Viral Hepatitis D.

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