Everything you need to know about Hepatitis D

Hepatitis D is also known as Delta Hepatitis. According to the World Health Organization (WHO), the Hepatitis D virus (HDV) requires the Hepatitis B virus (HBV) for its replication and thriving.  The WHO explains that Hepatitis D usually occurs when people become infected with both hepatitis B and D at the same time. This type of infection is referred to as co-infection. This infection also occurs when a person gets Hepatitis D after being infected with Hepatitis B. This is referred to as super-infection.

“The Hepatitis D –  Hepatitis B co-infection is the most severe form of chronic viral hepatitis due to the higher rate of rapid progression towards hepatocellular carcinoma and liver-related death,” the WHO states. A WHO research conducted in 2020 showed that the Hepatitis D virus affects nearly 5 percent of people who have a chronic infection with the Hepatitis B virus. This research also showed Hepatitis D co-infection is behind 1 in 5 cases of liver disease and liver cancer in people with Hepatitis B. “Hepatitis D super-infection will usually accelerate the progression of the illness to cirrhosis (liver disease) almost a decade earlier than Hepatitis in patients without co-infection. Patients with Hepatitis D-induced cirrhosis are at an increased risk of hepatocellular carcinoma,” the WHO states.

Transmission

The method of spread of Hepatitis D is very similar to that of Hepatitis B. According to the Centre for Disease Control (CDC), Hepatitis D is spread mainly through the puncturing of the skin and when blood or other body fluids from a person infected with the virus enters the body of someone who is not infected. This exposure can be through shared things such as injections, tattooing objects, and needles. “Hepatitis D can be an acute disease, a short-term infection or it can also become a long-term, chronic infection,” the CDC states. While it is possible for this virus to spread from a mother to a child during childbirth, instances of mother-to-child transmission during birth are very rare in comparison to other methods of transmitting the virus travels by.

There are certain groups of people who will be at higher risk of contracting this virus than others. For example, people with Hepatitis B will be at a higher risk of getting Hepatitis D. In addition, the WHO singles out people who inject drugs, people with the hepatitis C virus, and people living with the HIV infection as being at increased risk of getting Hepatitis D co-infection (simultaneous infection with Hepatitis B and Hepatitis D). “The risk of co-infection also appears to be potentially higher in recipients of haemodialysis, men who have sex with men, and commercial sex workers,” the WHO states. The CDC however points out that Hepatitis D is not spread through food or water, sharing eating utensils, breastfeeding, hugging, kissing, hand-holding, coughing, or sneezing.”

The symptoms

The symptoms associated with Hepatitis D can become so aggravated that they result in a serious ailment that leads to death or life-long liver damage. Like other types of Hepatitis, the WHO states that the symptoms associated with this condition will include fever, fatigue, loss of appetite, nausea, vomiting, dark urine, abdominal pain, joint pain, pale-colored stools, and jaundice. These symptoms tend to show within three to seven weeks after an uninfected person comes into contact with and gets infected with the virus. According to the CDC, people who acquire chronic Hepatitis B in childhood are likely to have liver problems in adulthood, with a potential onset of the liver disease from the age of 40 years.

Prevention and treatment

The Hepatitis D infection is usually prevented through the Hepatitis B immunisation. “This method of immunisation includes a timely birth dose, additional antiviral prophylaxis for eligible pregnant women, blood safety, safe injection practices in health care settings, and harm reduction services with clean needles and syringes,” the WHO recommends. However, Hepatitis B immunisation will not provide protection against Hepatitis D for individuals who have already been infected with Hepatitis B. Treatment for Hepatitis D should last for at least 48 weeks. This treatment period should be fully covered irrespective of the patient’s response. “The virus tends to give a low rate of response to the treatment; however, the treatment is associated with a lower likelihood of disease progression,” the WHO states in its Hepatitis D treatment guidelines.

Takeaway point

According to the WHO, Hepatitis D is not common in the East African region. However, it is largely common in the West and Central Africa regions.