What is hepatitis D?
Hepatitis D (also known as hepatitis delta) is a liver disease caused by a small spherical enveloped RNA virus known as the hepatitis D virus (HDV). However, it is a defective virus and to cause disease it requires the help of HBV. Hence, both HDV and HBV need to be present together to cause hepatitis D disease.
Who gets hepatitis D?
HDV is found only in patients who are infected with the HBV. HDV may worsen the condition of liver disease patients who have either acute (recent) or chronic (long-term) hepatitis B. HDV may lead to development of symptoms in patients with HBV who were till now asymptomatic.
Where is hepatitis D found?
Approximately 15 million people are infected with HDV globally. Countries with the highest prevalence of hepatitis D include Italy, North African countries, the Middle East, the Amazon Basin and the American South Pacific islands. Asian countries like China, Japan, Taiwan and Myanmar have a very high prevalence of HBV infection but a low rate of HDV infection. Hepatitis D is not very common in India.
What does hepatitis D do to the body?
HDV cannot cause disease on its own. It can cause disease only in patients who are already infected with hepatitis B. Hepatitis D disease can either be acute or chronic. Acute hepatitis D occurs rapidly (within weeks) and usually causes serious symptoms and then it may subside on its own. However, if the infection persists for more than 6 months, then the disease is called chronic hepatitis D. The symptoms of chronic hepatitis D develop gradually over months to years. HDV might be present in the body for several months or years before any symptoms occur. The chances of complications increase with passage of time. Many patients with chronic hepatitis D may develop cirrhosis and liver cancer.
What is the treatment for hepatitis D?
Treatment of infection with HDV consists primarily of supportive measures. No pharmacologic treatment for hepatitis D has been approved. Few studies have found that treatment with peg-interferon injections for 1 year may lead to clearance of HDV in approximately 25% of patients.
The patients should be closely monitored with periodic liver function tests and monitored for complications of liver disease. Patients with evident deterioration to decompensated liver disease or development of fulminant liver failure due to hepatitis D should be immediately transferred to a centre capable of performing a liver transplantation.