Delta agent (Hepatitis D)

Definition

Hepatitis D infection involves a defective viral agent that causes symptoms only in association with hepatitis B infection.

Causes, incidence, and risk factors

Hepatitis D virus may worsen an  acute hepatitis B infection or existing hepatitis B liver disease. It can cause symptoms in previously asymptomatic hepatitis B carriers.

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

Risk factors include:

• Previous hepatitis B infection
• Being a carrier of hepatitis B
• Receiving many blood transfusions
• Intravenous drug abuse

Symptoms

Hepatitis D may increase the severity of symptoms associated with all forms of hepatitis B.

Signs and tests

• Liver enzymes are elevated.
• Anti-delta agent antibody is positive.
• Liver biopsy shows acute hepatitis.

Treatment

Treatment is the same as for hepatitis B.

Expectations (prognosis)

Expectations are similar to those of acute hepatitis B. The acute illness usually subsides over 2 to 3 weeks, and the liver enzyme levels return to baseline within 16 weeks.

About 10% of people infected may develop chronic hepatitis.

Complications

• Chronic active hepatitis
• Fulminant hepatitis

Calling your health care provider

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

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.

There is a vaccine available to prevent hepatitis B and should be considered by people who are at risk due to IV drug use, exposure to blood products, or sexual behaviors.

Illustrations

Hepatitis B virus

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Hepatitis D virus ; d hepatitis virus