What Is Hepatitis D?

Medically Reviewed by Minesh Khatri, MD on November 14, 2022

What Is Hepatitis D?

Hepatitis D is a liver infection you can get if you have hepatitis B. It can cause serious symptoms that can lead to lifelong liver damage and even death. It’s sometimes called hepatitis delta virus (HDV) or delta hepatitis.

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.

Hepatitis D Symptoms

The signs of HDV can include:

If you already have hepatitis B, HDV can make your symptoms worse.

Hepatitis D Causes

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 infect you only 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.

Risk Factors

Your odds of getting hepatitis D go up if you:

  • Have hepatitis B
  • Inject drugs
  • Have sex with someone who has hepatitis B or D
  • Have HIV and hepatitis B
  • Are a man who has sex with other men


Hepatitis D Transmission

You can get hepatitis D only after coming into contact with the blood or other body fluids of someone who has it. This can happen if you:

  • Have sex with someone who has the virus
  • Share needles used to inject drugs
  • Touch the open sores of someone who has the virus
  • Get a needle stick that was in contact with an infected person
  • Share personal items like razors or toothbrushes that may have touched an infected person’s blood

It’s rare, but mothers can also give HDV to their babies during birth.

Hepatitis D Diagnosis

Your doctor will ask questions about your symptoms and lifestyle, then do an exam. They’ll test your blood for the different types of hepatitis. If you have it, your doctor will do more bloodwork and imaging tests to check your liver for signs of damage.

Hepatitis D Treatment

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 to 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).

Peg-IFNa doesn’t work well for everyone. It can also cause many side effects, like lack of energy, weight loss, flu-like symptoms, and mental health issues like depression.

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 1 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 may recommend a liver transplant.

Hepatitis D Prevention

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.

Don’t share needles if you inject drugs.

  • If you already have hepatitis B, you can lower your risk of HDV. This means:
  • 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.

Show Sources


CDC: “Hepatitis D,” “Hepatitis D Questions and Answers for the Public.”

Hepatitis B Foundation: “What is Hepatitis D?”

Children’s Hospital of Philadelphia: “Hepatitis D.”

F1000Research: “Recent advances in managing hepatitis D.”

National Institute of Diabetes and Digestive and Kidney Diseases: “Hepatitis D.”

Children’s Hospital of Philadelphia: “Hepatitis D.”

American Liver Foundation: “Treating Hepatitis C.”

World Journal of Gastroenterology: “Management of hepatitis delta: Need for novel therapeutic options.”

Hepatitis C Online/Infectious Diseases Education and Assessment: “Peginterferon alfa-2a (Pegasys.)”

Virology Journal: “Hepatitis Delta: virological and clinical aspects,” “Hepatitis Delta Virus.”

World Journal of Virology: “Hepatitis delta virus: A fascinating and neglected pathogen.”

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