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Gastrointestinal

Delta agent (Hepatitis D)

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Definition

Delta agent is a type of virus called hepatitis D that causes symptoms only in people who also have a hepatitis B infection.

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 recent (acute) hepatitis B infection or an existing long-term (chronic) hepatitis B liver disease worse. It can even cause symptoms in people who carry hepatitis B virus but who never had symptoms.

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

Risk factors include:

  • Abusing intravenous (IV) or injection drugs
  • Being infected while pregnant (the mother can pass the virus to the baby)
  • Carrying the hepatitis B virus
  • Men having sexual 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 (blood test)

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 diagnosis 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. Adults who are at high risk for hepatitis B infection, and all children should consider getting this vaccine.

References

Perrillo R. Hepatitis B and D. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier;2010:chap 78.

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