Hepatitis D virus (HDV) is a virus that affects the liver and can cause infection only in the presence of hepatitis B virus. Although it is seen less frequently than other types of viral hepatitis, it can cause inflammation in the liver and, in some cases, may be associated with long-term liver damage. Awareness of the symptoms, routes of transmission, and prevention methods of hepatitis D can contribute to increasing knowledge about the disease.
What Is Hepatitis D Virus?
Hepatitis D virus (HDV) is a virus that can cause infection only in individuals who have hepatitis B infection. Also known as delta virus, this infection can cause inflammation in the liver and, in some cases, may be associated with long-term liver damage.
What Are the Types of Viral Hepatitis?
The main viruses that affect the liver and cause infections known as viral hepatitis are hepatitis A, hepatitis B, hepatitis C, hepatitis D, and hepatitis E viruses. The routes of transmission, disease course, and effects on the liver differ from one virus to another. Hepatitis D virus differs from other types of viral hepatitis in that it can cause infection only in the presence of hepatitis B virus.
Hepatitis A Virus (HAV)
It is a type of hepatitis that is usually transmitted through contaminated water and food. In most cases, it may not lead to chronic infection.
Hepatitis B Virus (HBV)
Hepatitis B virus, which can be transmitted through blood and body fluids, can cause acute or chronic liver infection.
Hepatitis C Virus (HCV)
It is mostly transmitted through contact with infected blood. It can progress for many years without causing symptoms and may lead to chronic liver disease.
Hepatitis D Virus (HDV)
Hepatitis D virus (HDV), also known as delta virus, is a virus whose genetic material is composed of RNA. To replicate, it requires the surface antigen of hepatitis B virus. For this reason, it can only be seen in individuals who have hepatitis B infection.
Hepatitis E Virus (HEV)
It is usually transmitted through contaminated water in areas with inadequate hygiene conditions and most often presents as an acute infection.
What Is the Difference Between Hepatitis D and Hepatitis B?
While hepatitis B virus can cause infection on its own, hepatitis D virus requires hepatitis B virus in order to cause infection. Therefore, hepatitis D can be seen only in individuals who have hepatitis B infection.
How Is Hepatitis D Transmitted?
Hepatitis D virus can be transmitted through infected blood, body fluids, and non-sterile medical or cosmetic procedures.
The most common routes of hepatitis D transmission can be listed as follows:
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Transfusion of infected blood or blood products,
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Shared use of non-sterilized syringes,
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Procedures such as tattooing, piercing, and acupuncture being performed in unhygienic environments with inadequate sterilization,
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Sharing personal care items such as razors, nail clippers, and toothbrushes,
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Unprotected contact with infected body fluids,
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Although rare, vertical transmission from an infected mother to her baby during birth.
Hepatitis D virus is not transmitted through casual daily social contact; it is mainly transmitted through contact with infected blood and certain body fluids.
What Are the Symptoms of Hepatitis D?
Hepatitis D virus infection may remain asymptomatic for a long time in some individuals. The most common symptoms of hepatitis D are fatigue, tiredness, jaundice, abdominal pain, loss of appetite, and dark-colored urine.
Commonly observed symptoms include:
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Severe weakness, chronic fatigue, and loss of energy,
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Noticeable yellowing of the whites of the eyes and the skin,
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Darkening of urine color and lightening of stool color,
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A feeling of fullness or dull pain in the right upper quadrant, in the liver region,
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Weight loss due to nausea, vomiting, and loss of appetite,
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Joint pain.
In chronic cases, the disease may progress silently for many years without showing symptoms and may present directly with signs of advanced liver cirrhosis.
What Diseases Can Hepatitis D Cause?
Hepatitis D virus is an infection that causes inflammation in the liver and may lead over time to damage in liver tissue. Especially when it occurs together with hepatitis B infection, the course of the disease may be more severe and the risk of developing certain liver diseases may increase.
Health problems that may be associated with hepatitis D infection include:
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Acute and Fulminant Hepatitis: This is suddenly developing liver inflammation. In some patients, hepatitis D infection may have a more severe course and be associated with serious complications such as liver failure.
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Chronic Delta Hepatitis: If individuals who already carry hepatitis B virus in their body later become infected with HDV, the disease may become chronic.
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Liver Cirrhosis: HDV infection is considered one of the factors that can increase the rate of progression of liver fibrosis. Therefore, compared with patients who have only hepatitis B, chronic patients may develop liver cirrhosis at a younger age.
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Liver Cancer: Acceleration of progression to cirrhosis and chronic cellular-level damage may be associated with an increased risk of developing liver cancer.
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Portal Hypertension and Related Complications: As a result of increased pressure in intrahepatic vessels due to cirrhosis, secondary clinical conditions such as fluid accumulation in the abdomen, esophageal bleeding, and enlargement of the spleen may develop.
Hepatitis D is an infection that can be associated with acute hepatitis, chronic hepatitis, liver fibrosis, liver cirrhosis, liver failure, and liver cancer. The course of the disease may vary from person to person.
Who Is More Commonly Affected by Hepatitis D?
Since hepatitis D virus can cause infection only in the presence of hepatitis B virus, it is more frequently seen in certain groups, particularly individuals with hepatitis B infection.
People who may be at risk include:
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Patients with chronic hepatitis B
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Hepatitis B carriers
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Individuals at risk of contact with infected blood
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Individuals who share syringes
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Healthcare workers
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Individuals at risk of unprotected sexual contact
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People who have tattoos and piercings done under non-sterile conditions
In these groups, the risk of developing hepatitis D infection may be higher than in the general population. Therefore, in individuals with hepatitis B infection, evaluation for hepatitis D may be recommended when deemed necessary.
How Is Hepatitis D Diagnosed?
The diagnosis of hepatitis D is made by evaluating the person’s medical history, performing a physical examination, and reviewing laboratory tests together. Especially in individuals with hepatitis B infection, various blood tests can be used to investigate the presence of hepatitis D.
Methods that can be used in diagnosis include:
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Anti-HDV (hepatitis D antibody) tests
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HDV RNA tests
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Blood tests related to hepatitis B
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Liver function tests
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Imaging methods when necessary
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Liver biopsy in some patients
These tests are used to evaluate the presence of infection, the activity of the virus, and its effects on the liver.
How Is Hepatitis D Treated?
Treatment of hepatitis D can be planned according to the severity of the infection, the condition of the liver, and the patient’s overall health status. The aim of treatment is to reduce the effects of the virus on the liver and to keep the progression of the disease under control.
The treatment approach is determined on an individual basis. During the treatment process, the activity of the virus, the status of the accompanying hepatitis B infection, and the current liver functions are taken into account. While regular follow-up may be sufficient in some patients, in other cases treatment options deemed appropriate by the physician may be considered.
How Can Hepatitis D Be Prevented?
Since the hepatitis D virus (HDV) can only cause infection in the presence of the hepatitis B virus (HBV), one of the most important ways to prevent hepatitis D is to prevent hepatitis B infection. Vaccination against hepatitis B can indirectly provide protection against hepatitis D infection.
The main methods recommended for preventing hepatitis D infection include:
- Hepatitis B Vaccination: Immunity developed through hepatitis B vaccination may also provide indirect protection against hepatitis D infection.
- Avoiding the Sharing of Personal Items: Not sharing personal items such as toothbrushes, razors, and nail clippers can help reduce the risk of transmission.
- Avoiding the Use of Non-Sterile Needles: Refraining from sharing needles and syringes can significantly reduce the risk of blood-borne transmission.
- Choosing Hygienic Tattoo and Piercing Procedures: Tattooing, piercing, and acupuncture procedures should be performed in environments that comply with proper sterilization standards.
- Regular Monitoring of Hepatitis B Carriers: Individuals with chronic hepatitis B infection or those who carry the hepatitis B virus may be advised to undergo evaluation for hepatitis D when considered appropriate by healthcare professionals.
Frequently Asked Questions
Is hepatitis D contagious?
Yes, hepatitis D is a contagious infection. However, transmission usually occurs through contact with infected blood or certain body fluids; it is not transmitted through casual daily social contact.
Can a person vaccinated against hepatitis B get hepatitis D?
In individuals who develop adequate immunity with the hepatitis B vaccine, the risk of hepatitis D infection is significantly reduced. This is because hepatitis D virus needs hepatitis B virus in order to replicate.
Do hepatitis D symptoms appear immediately?
Hepatitis D infection may progress for a long time without causing symptoms in some individuals. When symptoms do appear, complaints such as fatigue, loss of appetite, nausea, abdominal pain, and jaundice may be seen.
Is it possible to prevent hepatitis D?
Since hepatitis D virus can cause infection only in the presence of hepatitis B virus, vaccination programs against hepatitis B are important for prevention. In addition, avoiding sharing personal items such as toothbrushes and razors, and paying attention to sterilization rules during procedures such as tattoos or piercings can help reduce the risk of transmission.
