HEPATITIS D VIRUS

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What Is It?

Hepatitis D (HDV) is a viral infection that only infects individuals who are also infected with hepatitis B virus. Approximately 5% of those with hepatitis B also have hepatitis D.

How can you get it?

Hepatitis D is transmitted just as hepatitis B, through contact with the blood or body fluids of a person infected with HDV. The risk factors are similar:

  • Exposure to blood through a needle stick or cut from sharp instrument
  • Contact with blood or open sores of an infected patient to mucous membranes or broken skin
  • Sharing personal care items with an infected person (ex. razors, toothbrushes)
  • Injection Drug Use, Sexual Activity, Mother-to-Child

HDV presents in two different forms:

  • Co-infection Infection with HDV and HBV at the same time
  • Superinfection Infection with HBV first, then later infection with HDV

What are the symptoms?

HDV can worsen an acute or chronic hepatitis B infection. The signs and symptoms of hepatitis D may include:

  • Fatigue
  • Yellowing of the skin and eyes (called jaundice)
  • Abdominal pain
  • Nausea and/or vomiting

The symptoms typically last 2 to 3 weeks but complications of HDV infection include chronic liver inflammation in 10% of those infected. Complete liver failure may also occur. Those who experience a co-infection with HBV are likely to recover while those with a superinfection are more likely to develop chronic infection and liver failure.

How do you prevent it?

The “best way to prevent hepatitis D is to be vaccinated against hepatitis B.” You can help prevent the spread of HDV by following a comprehensive OSHA required program for Bloodborne pathogen exposures which includes the following:

  • Getting vaccinated against Hepatitis B
  • Prompt treatment of any Hepatitis B infection
  • Sharps Safety
    • Training and consistent use of safer needle techniques and devices
    • Proper sharp disposal
  • Using Universal Precautions
    • Hand hygiene (wash with soap and water or using an alcohol based hand rub)
    • Personal protective equipment (PPE) (gloves, gowns, masks and goggles that offer mouth, nose and eye protection)
    • Proper handling and disposal of instruments/devices and clothing contaminated with blood or body fluids

What should you do if you are exposed to the disease or get the disease?

Immediately following an exposure:

  • Wash needlesticks and cuts with soap and water
  • Flush splashes to the nose, mouth, or skin with water
  • Irrigate eyes with clean water, saline, or sterile solutions

As soon as possible, report the exposure and seek medical care

  • Determining hepatitis B status is important since the bloodborne pathogen hepatitis D is an incomplete virus that requires hepatitis B infection.
    • If you are exposed to hepatitis B, it is an OSHA requirement that you are offered an evaluation for bloodborne pathogen exposure.
    • This will include having blood drawn as soon as possible to determine your baseline serologic status. This test determines if you have protective antibodies.
    • If you do not have protective antibodies to hepatitis B, your healthcare provider may decide to give you the vaccine and/or hepatitis B Immune Globulin (HBIG) for immediate protection.

The medication alpha interferon has been used to manage some of the inflammation but there is no cure for hepatitis D. Since hepatitis D can be acquired following infection with hepatitis B, those infected with hepatitis B should protect their liver from further damage, by getting immunized for hepatitis A, avoiding alcohol, avoiding risk factors listed above and having continuing medical care.

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