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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
- 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.
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.
