Delta agent (Hepatitis D)

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

  • Alternative Names
    • Hepatitis D virus

  • Causes
    • Hepatitis D virus (HDV) is found only in people who carry the hepatitis B virus. HDV may make liver disease worse in people who have either recent (acute) or long-term (chronic) hepatitis B. 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 a small number 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 worse.

      Symptoms may include:

      • Abdominal pain
      • Dark-colored urine
      • Fatigue
      • Jaundice
      • Joint pain
      • Loss of appetite
      • Nausea
      • Vomiting
  • Exams and Tests
  • Treatment
    • Many of the medicines used to treat hepatitis B are not helpful for treating hepatitis D.

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

  • Outlook (Prognosis)
    • People with an acute HDV infection most often get better over 2 to 3 weeks. Liver enzyme levels return to normal within 16 weeks.

      About 1 in 10 of those who are infected may develop long-term (chronic) liver inflammation (hepatitis).

  • Possible Complications
    • Complications may include:

      • Chronic active hepatitis
      • Fulminant hepatitis
  • When to Contact a Medical Professional
    • Call your health care provider if you have symptoms of hepatitis B.

  • Prevention
    • Steps to prevent the condition include:

      • Detect and treat hepatitis B infection as soon as possible to help prevent hepatitis D.
      • Avoid intravenous drug (IV) abuse. If you use IV drugs, avoid sharing needles.
      • Get vaccinated against hepatitis B.

      Adults who are at high risk for hepatitis B infection and all children should get this vaccine. If you do not get Hepatitis B, you cannot get Hepatitis D.

  • 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: Elsevier Saunders; 2010:chap 78.