The Alphabet Soup of Virus Hepatitis: Hepatitis D

What is Hepatitis D?

Hepatitis D is a virus that is found in association with Hepatitis B. It is a defective transmissible virus that needs Hepatitis B for its replication. It is a RNA virus.

How is Hepatitis D acquired?

There is a worldwide distribution of delta hepatitis or Hepatitis D in association with Hepatitis B it is uncommon in South East Asia but more common in Italy, Middle East and parts of South America. It can be infected at the same time as Hepatitis B (coinfection). Persons already having Hepatitis B could then be subsequently infected by Hepatitis D (superinfection). In such a situation, Hepatitis D replicates very quickly and is more likely to cause fulminant hepatitis as well as chronic hepatitis.

What are the symptoms?

Hepatitis D is associated with both acute and chronic hepatitis. Chronicity and fulminant hepatitis are more likely with “superinfection” than “coinfection”.

Can it be treated?

There is no specific treatment for Hepatitis D. The treatment is to treat the underlying Hepatitis B (see other article) since Hepatitis D is dependent for existence on Hepatitis B.

What is the outcome?

In coinfection the course of infection is usually self-limiting and chronic hepatitis occurs in less than 10% of patients. In fact, Hepatitis D may suppress Hepatitis B. However in superinfection, chronic hepatitis is more likely and so is fulminant hepatitis.

Can I vaccinate against it?

There is no vaccine against Hepatitis D virus. However immunity against Hepatitis B also protects against Hepatitis D.

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