Hepatitis D primary prevention

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Varun Kumar, M.B.B.S. [2]

Overview

Prevention

Protection against hepatitis D among drug users can be accomplished by vaccinating against hepatitis B. Since HDV infection requires that the person be co-infected with HBV, vaccinating against hepatitis B also confers immunity to hepatitis D. Some 3 to 4 percent of healthy recipients have no response to the hepatitis B vaccine.

  • Prompt recognition and treatment of hepatitis B infection can help prevent hepatitis D.
  • Avoid intravenous drug abuse. If you use IV drugs, avoid sharing needles.
  • A vaccine is available to prevent hepatitis B. It should be considered by people who are at high risk for hepatitis B infection.
  • pre or post-exposure prophylaxis (hepatitis B immune globulin or vaccine) to prevent HBV infection
  • HBV-HDV superinfection
  • education to reduce risk behaviors among persons with chronic HBV infection [1]

Special care should be taken in clinical settings to avoid accidental sticks with needles, syringes, and other sharp instruments and to follow proper sterilization or disposal procedures. Universal precautions apply for drawing blood or other medically related procedures.

Children A child with known hepatitis D should be excluded if he or she exhibits any of the following:[2]

  • Weeping sores that cannot be covered
  • Biting or scratching behavior
  • A bleeding problem
  • Generalized dermatitis that may produce wounds or weepy tissue fluids
  • Unable to participate in routine activities, needs more care than can be provided by staff, or meets other

exclusion criteria, such as fever with behavioral change

The child can be readmitted to a group setting when skin sores are dry or covered, when the child is cleared to return by a health professional, or when the child is able to participate in activities.

HIV Infected Patients HIV-infected persons may not develop protective immunity after receiving hepatitis B vaccine. They therefore remain at risk for infection with HBV and HDV.[3]

Pregnant Patients Pregnant women should be screened for hepatitis B infection. If the 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. http://www.cdc.gov/ncidod/diseases/hepatitis/d/fact.htm
  2. http://www.ndhealth.gov/disease/documents/faqs/hepatitis%20d.pdf
  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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