Hepatitis D

What is it? 

  • Hepatitis D, also called delta virus, also known as an  incomplete virus that requires the helper function of hepatitis B virus to multiply and is therefore only found in people who are already infected with hepatitis B. Hepatitis D is the least common but most severe form of viral hepatitis
  • Hepatitis D  can be an acute, short-term, infection or a long-term, chronic infection
  • Hepatitis D infection only occurs as a co-infection, which means it occurs at the same time as hepatitis B infection; or it can occur as a super infection in people who have chronic hepatitis B.
  • It is rare in Australia but people who are infected with hepatitis D and hepatitis B have a higher risk of developing chronic liver disease and cirrhosis (scarring of the liver).i

How is it transmitted? 

  • Hepatitis D is spread in similar ways to hepatitis B because the virus is found in blood.
  •  Blood to blood

Activities which place people at risk

  • Sharing injecting and auxiliary equipment
  • Tattooing and skin piercing with contaminated equipment
  • Sharing toothbrushes, combs, & razors

Short term effects 

“The symptoms of hepatitis D are similar to hepatitis B

  • loss of appetite
  • nausea and vomiting
  • tiredness
  • pain in the liver (upper, right side of abdomen)
  • muscle and joint pain
  • Jaundice (yellowish eyes and skin, dark urine and pale-coloured faeces.” (CDC 2006)

Long term effects 

  • People who are infected with hepatitis D and hepatitis B have a higher risk of developing chronic liver disease and cirrhosis (scarring of the liver)

Vaccination? 

  • Hepatitis B vaccination prevents hepatitis D

Prevention

  • Hepatitis B vaccination prevents hepatitis D for people who are chronically infected with hepatitis B
  • If you have chronic hepatitis B harm reduction practices are the only protection.
  • No sharing of all injecting and auxiliary equipment
  • Ensure sterile equipment for tattooing and skin piercing
  • Follow Universal Precautions when managing body fluids
  • Avoid sharing toothbrushes, combs, and razors
  • Safe sexual practices that ensure blood is not transmitted

Testing 

  • Co-infection and super infection with hepatitis D can be diagnosed by a blood test which, if positive, will show antibodies against the hepatitis D virus

Monitoring 

Discuss the protocols for monitoring your liver health with your gastroenterologist

Treatment 

There is no specific treatment for hepatitis D. Research indicates that the medication used to treat hepatitis B has a limited effect on the activity of hepatitis D virus. Clinical trials using Pegylated interferon have demonstrated some benefit in people with hepatitis D

More information 

http://www.cdc.gov/hepatitis/hdv/index.htm

http://www.hepatitisaustralia.com/hepatitis-d/