Delta agent (Hepatitis D)

• Alternative Names

  Hepatitis D virus

• Causes, incidence, and risk factors

  Hepatitis D virus (HDV) is only found in people who carry the hepatitis B virus. HDV may make a hepatitis B infection or existing hepatitis B liver disease worse. It can cause symptoms in people with hepatitis B virus who never had symptoms.

  Hepatitis D infects about 15 million people worldwide. It occurs in 5% of people with hepatitis B.

  Risk factors include:

  • Abusing intravenous (IV) drugs
  • Being infected while pregnant (the mother can pass the virus to the baby)
  • Carrying the hepatitis B virus
  • Having had a hepatitis B infection in the past
  • Men having intercourse with other men
  • Receiving many blood transfusions
• Symptoms

  Hepatitis D may make the symptoms of hepatitis B more severe.

  Symptoms may include:

  • Abdominal pain
  • Dark-colored urine
  • Fatigue
  • Jaundice
  • Joint pain
  • Loss of appetite
  • Nausea
  • Vomiting
• Signs and tests
  • Anti-delta agent antibody
  • Liver biopsy
  • Liver enzymes
• Treatment

  Many of the medicines used to treat hepatitis B are not helpful for treating hepatitis D. See hepatitis B.

  Persons with long-term HDV infection may receive a medicine called alpha interferon for up to 12 months. A liver transplant for end-stage chronic hepatitis B may be effective.

• Expectations (prognosis)

  Persons with an acute HDV infection usually get better over 2 to 3 weeks. Liver enzyme levels return to normal within 16 weeks.

  About 10% of those who are infected may develop long-term (chronic) liver inflammation (hepatitis).

• Complications
  • Chronic active hepatitis
  • Fulminant hepatitis
• Calling your health care provider

  Call for an appointment with your health care provider if you have symptoms of hepatitis B.

• Prevention

  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.

• References

  Dienstag JL. Chronic viral hepatitis. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 6th ed. Philadelphia, Pa: Elsevier Churchill Livingstone;2005:chap 112.

Review Date: 2/21/2009

Reviewed By: George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.