Delta agent (Hepatitis D)
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 disease worse. 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: 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.
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