Hepatitis Delta Virus

Description

Hepatitis D is a rare liver disease caused by the Hepatitis D Virus (HDV), which only affects people who also have hepatitis B. It’s more common in parts of Asia, Africa, Eastern Europe, and South America. The virus spreads through contact with infected blood or body fluids. Hepatitis D can cause more severe liver damage than hepatitis B alone. Over time, it may lead to liver scarring (cirrhosis), liver failure, or liver cancer. Some people have no symptoms at first, while others may feel very tired, have yellow skin or eyes (jaundice), and pain in the upper right abdomen.

Diagnosis

To diagnose hepatitis D, doctors first check if a person has hepatitis B, since hepatitis D only occurs in people with hepatitis B infection. If hepatitis B is confirmed, a blood test is done to look for antibodies to hepatitis D. If positive, another test checks for the virus itself (HDV RNA) to see if the infection is active. Symptoms like fatigue, jaundice, or liver pain may raise suspicion, but some people have no symptoms. Diagnosis can be delayed because hepatitis D is rare and not always tested for. Early testing is important to begin treatment and prevent liver damage.

The first specific approved medicine for hepatitis D is bulevirtide, which helps block the virus from entering liver cells. In some cases, it may be combined with other treatments like interferon, though this can have mild to moderate side effects. These treatments aim to control the virus, and the rates of successful viral clearance are modest. Supportive care includes regular monitoring and healthy lifestyle changes.  If the liver becomes severely damaged, a liver transplant may be needed. New treatments are being studied in clinical trials, offering hope for more effective therapies in the future.

Management

Living with hepatitis D means regular check-ups and healthy lifestyle choices. People should avoid alcohol, eat a balanced diet, stay physically active, and manage other health conditions like diabetes. At the clinics liver function and virus levels will be monitored through blood tests every few months. Imaging like liver ultrasounds may be done to check for progression of liver disease or development of liver cancer. Care is usually lead by a hepatologist or infectious disease specialist and a specialized nurse.