If you have hepatitis B, you’re at risk for another virus that attacks your liver: hepatitis D (HDV), or what’s sometimes called hepatitis delta. Although it isn’t common in the United States, HDV is the most severe form of hepatitis. Over time, it can lead to liver cancer or liver failure. While treating HDV can be a challenge, doctors are hopeful that better treatments are on the way.
What Causes It?
You can get HDV if you come into contact with the blood or other body fluid of someone who’s sick with it. Yet it can only infect you if you have hepatitis B. HDV needs the “B” strain of hepatitis to survive.
This can happen two ways:
- Co-infection: You can contract HBV and HDV at the same time
- Super-infection: You can get sick with hepatitis B first, then later come down with HDV. This is the most common way to get hepatitis D.
What Makes You More Likely to Get It?
Your odds go up if you have hepatitis B and:
- Inject drugs
- Have a sex partner who has HDV
- Are from a part of the world where HDV is common, such as Eastern and Southern Europe, the Middle East, or Central Africa
It’s rare, but mothers can also give HDV to their babies during birth.
What Are the Symptoms?
The signs of HDV can include:
- Yellow skin and eyes (jaundice)
- Stomach upset
- Pain in your belly
- Throwing up
- Not feeling hungry
- Joint pain
- Dark urine
- Light-colored stool
If you already have hepatitis B, HDV can make your symptoms worse.
How Do I Know I Have It?
Your doctor will ask questions about your symptoms and lifestyle, then do an exam. She’ll test your blood for the different types of hepatitis. If you have it, she’ll do more bloodwork and imaging tests to check your liver for signs of damage.
How Is Hepatitis D Treated?
If you have HDV, you may need to see a doctor who works with diseases of the digestive tract, including the liver, such as a gastroenterologist. Doctors called hepatologists specialize even further and treat only liver disease.
There’s no cure yet for HDV. Until doctors come up with better options, the drug prescribed most often is pegylated interferon alfa (peg-IFNa).
Doctors aren’t sure how long treatment for HDV should last. You may need to take peg-IFNa for a year. If a blood test still shows a certain amount of the virus in your body, your doctor may suggest that you stay on PEG-IFNa for up to one more year.
How Well Does Treatment Work?
How you respond to HDV treatment will depend on how you got sick with the virus.
Peg-IFNa is often able to clear HDV from most people who have a co-infection. If you have a super-infection, the virus is less likely to go away. You may need to learn to manage HDV and HBV as lifelong conditions.
Other types of HDV treatment are being tested. These include drugs that attack the virus or prevent it from latching on to hepatitis B cells that they need to survive.
If you have advanced liver disease, your doctor will recommend a liver transplant.
How Can I Keep From Getting HDV?
No vaccine can prevent HDV. The best way to avoid it is to cut your risk of getting hepatitis B. Talk to your doctor about getting an HBV vaccine. Avoid contact with blood or other body fluids of someone with hepatitis.
If you already have hepatitis B, you can lower your risk of HDV. This means:
- Don’t share needles if you inject drugs.
- Keep personal items like your toothbrush and razor separate.
- Wear gloves if you have to touch someone else’s open wound or sore.
If you have HDV, make healthy choices each day to protect your liver from further damage. Avoid alcohol, and talk to your doctor about ways to eat well. You’ll also want to take care not to infect others. Let your doctor and dentist know your diagnosis before each visit. It’s also not safe for others if you donate tissue, organs, blood, semen, or other body fluids.