Delta agent (Hepatitis D)

Answer 1

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

• Anti-delta agent antibody
• Liver biopsy
• Liver enzymes

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.

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.

Answer 2

Definition

Delta agent is a type of virus called hepatitis D that causes symptoms only in people who also 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 recent (acute) hepatitis B infection or an existing long-term (chronic) hepatitis B liver diseaseworse. It can even cause symptoms in people who carry hepatitis B virus but who never had symptoms.

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

Risk factors include:

• Abusing intravenous (IV) or injection drugs
• Being infected while pregnant (the mother can pass the virus to the baby)
• Carrying the hepatitis B virus
• Men having sexual 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

• Anti-delta agent antibody
• Liver biopsy
• Liver enzymes (blood test)

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.

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 diagnosis 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. Adults who are at high risk for hepatitis B infection, and all children should consider getting this vaccine.

References

Perrillo R. Hepatitis B and D. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier;2010:chap 78.

Reviewed By

Review Date: 11/23/2010

David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and 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.