Hepatitis D - You've Got What?
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Infection with hepatitis D virus (HDV) causes inflammation of the liver. Hepatitis D virus is also known as "delta hepatitis” and is considered the most severe form of viral hepatitis (hepatitis caused by a virus) in humans.
Hepatitis D only occurs in people who have hepatitis B. This is because hepatitis D virus is a defective (incomplete) virus and requires hepatitis B virus to survive and multiply. Hepatitis D is uncommon in Australia.
Hepatitis D is a notifiable condition1
Hepatitis D is spread when infectious body fluids (blood, saliva, semen and vaginal fluid) come into contact with body tissues beneath the skin (for example, through needle puncture or broken skin) or mucous membranes (the thin moist lining of many parts of the body such as the mouth, throat and genitals). In Australia most infections are associated with:
Symptoms are similar to those of hepatitis B and may include:
Image Courtesy Public Health Image Library (PHIL), Department of Health and Human Services, Centers for Disease Control and Prevention (CDC-USA) CDC,Dr. Thomas F. Sellers / Emory University
Sometimes people can become infected with both hepatitis B and hepatitis D at the same time (co-infection). While most people with co-infection will get rid of both viruses on their own, there is a higher risk (2 to 20%) of developing fulminant (overwhelming) hepatitis (acute liver failure).
When someone with hepatitis B virus later becomes infected with hepatitis D virus (superinfection) acute hepatitis D develops.
Most people with superinfection develop chronic hepatitis D infection with few, if any, symptoms initially, but are capable of spreading hepatitis D virus to others.
Most people with chronic hepatitis D (70 to 80%) develop cirrhosis (scarring of the liver). About one quarter of people with cirrhosis due to chronic hepatitis D infection will die of liver failure. People with cirrhosis are also at increased risk of developing liver cancer.
The diagnosis is based on signs and symptoms and confirmed with a blood test and/or PCR (polymerase chain reaction) test in a pathology laboratory.
Positive serology indicates previous exposure to hepatitis D virus while PCR testing is used to confirm the presence of the virus.
(time between becoming infected and developing symptoms)
Not known precisely but thought to be 2 to 8 weeks.
(time during which an infected person can infect others)
All people with hepatitis D are infectious.
There is currently no specific treatment for hepatitis D infection. Antivirals used to treat hepatitis B have little effect on hepatitis D. Long term follow up by a liver specialist is recommended.
1 – In South Australia the law requires doctors and laboratories to report some infections or diseases to SA Health. These infections or diseases are commonly referred to as 'notifiable conditions'.