Hepatitis D
What is hepatitis D?
Hepatitis D is a viral disease caused by hepatitis D RNA virus, a defective virus that needs the hepatitis B virus to exists. Infection from the causative virus can be prevented with the hepatitis B virus vaccine.
About the hepatitis D virus
The cause of this type of hepatitis is also called the delta virus. It occurs less often, but is the most severe form of viral hepatitis.
Because it needs the hepatitis B virus envelope to replicate, it is only found in people who are already infected with the hepatitis B virus.
Hepatitis D infection can occur simultaneously with hepatitis B infection or occur as a superinfection in people who already have chronic hepatitis B.
Co-infection with both types of hepatitis can cause very severe acute hepatitis and increases the risk of developing acute liver failure compared to people infected with hepatitis B alone.
However, most with co-infection manage to cure hepatitis D and the disease never goes into its chronic form.
What are the symptoms?
The symptoms of hepatitis D are similar to those of hepatitis B, but are often much more severe and long-lasting.
Usually they appear after a period of 2 to 6 months after contact with the virus. The time between infection and the onset of symptoms varies, but on average about 3 months pass.
This type of hepatitis differs from others because HDV infection requires the existence of hepatitis B infection at the same time, i.e. HDV is considered a satellite virus that requires a host virus (hepatitis B) to replicate and cause disease.
Here are some of the main symptoms of hepatitis D:
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Loss of Appetitet: Infected individuals usually experience a significant loss of interest in eating and lose their appetite. This symptom can lead to reduced food consumption and weight loss.
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Nausea and Vomiting: Hepatitis D can cause feelings of nausea and vomiting, which can be very irritating and dysfunctional for patients.
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Fatigue: People infected with hepatitis D often experience severe weakness and fatigue. This is due to the influence of the virus on the functions of the liver and the body as a whole.
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Pain in the area of the liver: Many patients with hepatitis D report pain or discomfort in the upper right side of the abdomen, where the liver is located. This symptom can be sharp and painful.
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Muscle and joint pain: Hepatitis D can cause muscle and joint pain in affected individuals, which can make them less active and less mobile.
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Jaundice: One of the most characteristic symptoms of hepatitis, whether B or D, is jaundice. It is manifested by yellowing of the white part of the eyes, darkening of the urine and pale coloring of the feces. Jaundice is the result of liver dysfunction in hepatitis virus infection.
These symptoms can be severe and lead to serious health problems, especially in the chronic form of hepatitis D.
Hepatitis D can progress to a chronic phase where the infection persists for a long period of time and can lead to cirrhosis of the liver or liver cancer.
Treatment of hepatitis D
There is currently no known specific treatment for the acute and chronic form of this type of viral infection. In the acute form, treatment is only aimed at relieving symptoms and strengthening the immune system to deal with the virus. Treatment in most cases does not require hospitalization. Antiviral medications are not effective.
The most common practice is to prescribe the injection of large doses of the drug interferonalfa 2b for a period of at least 12 months, with the injections taking place according to a scheme.
According to the World Health Organization, interferon causes remission of the disease. Even after the end of interferon therapy, however, and when performing blood tests afterwards, the presence of viral antigens or antibodies is detected.
In significantly advanced cirrhosis or other liver damage, a liver transplant may be necessary.
Liver transplantation is a complex surgical intervention in which the damaged organ is removed and replaced with a healthy one from the donor.
But even after such a major operation, there is a risk of infection of the transplanted organ as well, since the virus is not completely destroyed.
How to protect yourself?
Co-infection with hepatitis D can be prevented by vaccination against hepatitis B. Vaccination is given several times over 6 to 12 months depending on age. For example, adults are vaccinated three times in a period of 6 months.
Adolescents are vaccinated twice in a period of 4 to 6 months, and in infants four times in a period of more than 12 months.
Immunization against hepatitis B is included in the mandatory immunization calendar. The recombinant B vaccine Engerix is used, the first dose of which is administered intramuscularly in the first 24 hours after birth.
