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Hepatitis B virus
Hepatitis B virus


Delta agent (Hepatitis D)

Definition:

Delta agent is a type of virus called hepatitis D that causes symptoms only in people who have a hepatitis B infection.



Alternative Names:

Hepatitis D virus



Causes, incidence, and risk factors:

Hepatitis D virus (HDV) is only found in people who carry the hepatitis B virus. HDV may make a hepatitis B infection or existing hepatitis B liver disease worse. It can cause symptoms in people with hepatitis B virus who never had symptoms.

Hepatitis D infects about 15 million people worldwide. It occurs in 5% of people with hepatitis B.

Risk factors include:

  • Abusing intravenous (IV) drugs
  • Being infected while pregnant (the mother can pass the virus to the baby)
  • Carrying the hepatitis B virus
  • Having had a hepatitis B infection in the past
  • Men having intercourse with other men
  • Receiving many blood transfusions


Symptoms:

Hepatitis D may make the symptoms of hepatitis B more severe.

Symptoms may include:

  • Abdominal pain
  • Dark-colored urine
  • Fatigue
  • Jaundice
  • Joint pain
  • Loss of appetite
  • Nausea
  • Vomiting


Signs and tests:

Treatment:

Many of the medicines used to treat hepatitis B are not helpful for treating hepatitis D. See hepatitis B .

Persons with long-term HDV infection may receive a medicine called alpha interferon for up to 12 months. A liver transplant for end-stage chronic hepatitis B may be effective.



Support Groups:



Expectations (prognosis):

Persons with an acute HDV infection usually get better over 2 to 3 weeks. Liver enzyme levels return to normal within 16 weeks.

About 10% of those who are infected may develop long-term (chronic) liver inflammation (hepatitis).



Complications:
  • Chronic active hepatitis
  • Fulminant hepatitis


Calling your health care provider:

Call for an appointment with your health care provider if you have symptoms of hepatitis B.



Prevention:

Prompt recognition and treatment of hepatitis B infection can help prevent hepatitis D.

Avoid intravenous drug abuse. If you use IV drugs, avoid sharing needles.

A vaccine is available to prevent hepatitis B. It should be considered by people who are at high risk for hepatitis B infection.



References:

Dienstag JL. Chronic viral hepatitis. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 6th ed. Philadelphia, Pa: Elsevier Churchill Livingstone;2005:chap 112.




Review Date: 2/21/2009
Reviewed By: George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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