Hepatitis D (HDV) is an infection of the liver and is caused by the hepatitis delta virus. It is a small and incomplete virus and alone, it cannot cause an infection. Hepatitis D can occur only in conjunction with hepatitis B. Statistics from the National Institutes of Health indicate that 15 million people worldwide are infected with hepatitis D and five percent of all people who are infected with hepatitis B are infected with HDV. Co-infection of hepatitis B and D increases the risk of developing serious complications associated with chronic liver disease. The risks of chronic infection and remaining contagious for life are increased as well.
The early symptoms of hepatitis D are nausea, loss of appetite, joint pain, and fatigue. A mild fever may occur. An enlarged liver may cause pain in the right upper quadrant of the abdomen. Jaundice develops as the liver is unable to eliminate bilirubin, which is a yellow colored bile pigment found in red blood cells.
A series of blood tests are used to diagnosis hepatitis D. A quantitative hepatitis virus panel detects the presence of anti-delta agent antibodies. Liver enzyme levels are monitored. Occasionally, a liver biopsy is performed. Liver tissue is examined for the presence of cirrhosis, which is characterized by the replacement of healthy cells with scar tissue.
Many of the medications used to treat hepatitis B are not effective treatment for hepatitis D. Long-term HDV may be treated with alpha interferon and remission can be achieved. Recovery from acute HDV can occur within two to three weeks. Liver enzymes will return to normal levels within 16 weeks. It is estimated that 10 percent of patients with HDV will develop chronic hepatitis. Liver transplants are recommended for severe acute and advanced chronic cases of HDV.
Prompt diagnosis and treatment of hepatitis B can prevent the development of HDV. Individuals who are at risk for hepatitis B are advised to be vaccinated for this strain of hepatitis. Intravenous drug abuse should be avoided, but individuals who do use IV drugs are strongly advised not to share needles.
www.nilmnih.gov
www.digestive-disorders.health-cares.net
www.stanford.edu
Maryann Gromisch is a registered nurse with clinical experience in the areas of medical/surgical and critical care nursing. She has experience assisting a gastroenterologist in a private practice setting.