Facts About Hepatitis D Infection

Detailed Information about Hepatitis D Virus and the Infections it Causes

Woman suffering from abdominal pain.

Hepatitis D virus or HDV was discovered in the year 1977. The D of hepatitis D infection stands for the word delta. Structurally, it has been identified as an RNA virus. The most astonishing fact is that the structure of HDV is entirely different from that of HAV, HBV or HCV. Another unique feature of HDV is that it needs the help of HBV for the process of replication or initiating infection in liver cells.

An easy way to remember this feature of HDV is to imagine the meaning of D as "defective" or "dependent" as the virus depends on HBV. Genotypes of Hepatitis D are as follows:

  • Genotype I: This is spread throughout globally.
  • Genotype II: Areas of prevalence of this genotype are northern Asia, Japan and Taiwan
  • Genotype III: Prevalent mainly in South America

Transmission of Hepatitis D

The route of transmission is quite similar to that of Hepatitis B. It is transmitted from one person to another by coming in direct contact with infected blood. Hence IV drug users and individuals who have undergone multiple blood transfusions are regarded to be people at a greater risk of developing the infection. There are two very common words used along with HDV infection, which are as follows:

  • Co-infection: This is when a person is inflicted with HBV and HDV infection at the same time due to the strong association between both the two viruses.
  • Super-infection: This happens when the individual, who has HBV already (his blood samples show the presence of HBsAg) and is suffering from chronic hepatitis, is infected with HDV.

Clinical Presentation

On the basis of symptoms it is almost impossible to tell the difference between hepatitis D and other kinds of viral hepatitis.

Usually the person shows symptoms such as the following:

  • Abdominal pain
  • Nausea
  • Vomiting
  • Diarrhea
  • Dark colored urine
  • Jaundice
  • Pruritus
  • Fever

Very rarely, the person presents with symptoms like:

Diagnosis of Hepatitis D

Since the symptoms are not typical for hepatitis D, doctors conduct blood tests to find the type of virus that is causing hepatitis. Due to the strong association between HBV and HDV, doctors test those individuals who already have hepatitis B and showing a worsening of symptoms. Basically, the doctors look for antibodies generated against HDV in our body and conduct tests like PCR. On the basis of the results, doctors are able to diagnose if the HDV infection is in an acute or chronic stage.

Complications of Hepatitis D

Complications of this type of hepatitis are as follows:

  • Liver failure
  • Cancer of liver cells
  • Autoimmune response

How can I prevent Hepatitis D?

We must try to prevent any form of hepatitis. Hepatitis D when in combination with hepatitis B infection has been reported to have the highest mortality rate among all types of hepatitis. The best way to avoid hepatitis D infection is to prevent the occurrence of hepatitis B infection. This is possible if you get yourself immunized against HBV.

Ensure that all your family members have been vaccinated properly without missing any of their scheduled doses.

What is the Treatment for Hepatitis D?

To our misfortune, no sure-shot treatment for hepatitis D has been discovered in the field of medicine till now. In cases of acute hepatitis D infection, supportive care is regarded to be the most effective. If the person has chronic infection, the doctors start with antiviral medications like interferon- alpha which has shown to diminish the progression of disease to some extent. The course of treatment extends to a period of about one year or so.

Interferon can be used in children also as they are quite safe.

If the individual has undergone fulminant liver failure, liver transplantation is the only option left to cure him from his problems. After about 2 to 3 weeks, a person with an acute HDV infection recovers completely. The level of the liver enzyme takes around 16 weeks to bounce back to the normal level.


Horvath G, Hunyady B, Gervain J, Lengyel G, Makara M, Pár A, Szalay F, Telegdy L, Tornai I. Diagnosis and treatment of chronic hepatitis B and D. Hungarian national consensus guideline [Article in Hungarian]. Orv Hetil. 2014 Mar;155 Suppl:25-36.

Lau JY1, Portmann BC, Alexander GJ, Williams R. Differential effect of chronic hepatitis D virus infection on intrahepatic expression of hepatitis B viral antigen. J Clin Pathol. 1992 Apr;45(4):314-8.