AI Summary Hepatitis D is a liver infection caused by the hepatitis D virus (HDV). It can only infect people who already have hepatitis B, and it spreads through contact with infected blood. Symptoms include nausea, exhaustion, jaundice, and dark urine. Doctors diagnose it with an antibody test, then an HDV RNA test. No treatment is made specifically for it, though interferon and bulevirtide may help. The hepatitis B vaccine prevents both infections. Ask about testing if you have hepatitis B.
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Hepatitis D is a liver infection caused by the hepatitis D virus (HDV), also called delta hepatitis. The virus is incomplete: it can only infect people who already have hepatitis B, or who catch both viruses at the same time. It spreads through contact with infected blood. Hepatitis D is considered the most aggressive form of viral hepatitis. Among people with chronic hepatitis D, 60% to 70% develop cirrhosis, which can occur about 2 years after the infection begins.
There is no vaccine for hepatitis D, but the hepatitis B vaccine prevents both infections. Treatment options are limited, so testing and close monitoring by a liver specialist matter for anyone who has hepatitis B.
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About hepatitis D
Hepatitis D is a liver infection caused by the hepatitis D virus (HDV), also called delta hepatitis. It is an RNA virus that is structurally unrelated to the hepatitis A, B, and C viruses. Hepatitis D can be acute (short-term) or chronic (long-lasting).
Hepatitis D is an "incomplete" virus. It cannot make its own outer coat, so it borrows the surface proteins of the hepatitis B virus to multiply and spread. This is why hepatitis D can only infect people who already have hepatitis B, or who catch both viruses at the same time.
Hepatitis D is found worldwide, and more than 10 million people are infected. It is relatively uncommon in the U.S., except among people who use drugs and people with hemophilia.
People with chronic hepatitis D develop cirrhosis and its complications, including liver cancer, much faster than people with hepatitis B alone. The overall death rate from hepatitis D is 2% to 20%, about ten times that of hepatitis B alone.
Some people develop fulminant hepatitis, a severe form of the disease. Up to 5% of people who have hepatitis B and D together get it, and up to 20% of people with chronic hepatitis B and D get it. About 80% of people with fulminant hepatitis die.
How hepatitis D may feel
When symptoms appear, they usually start 14 to 180 days after infection. They look like many other illnesses, so they are easy to mistake for something else.
Getting checked
Hepatitis D can be suspected in anyone who has hepatitis B. Doctors use blood tests to look for the virus and to see whether it is active.
A positive hepatitis D antibody test is not enough on its own. An HDV RNA test is needed to confirm that the virus is active.
Care & treatment
There is no vaccine for hepatitis D and no treatment made specifically for it. Care focuses on preventing hepatitis B, slowing liver damage, and watching for complications.
Immunosuppressive therapy and antiviral drugs have shown no positive clinical effect on hepatitis D. Nucleoside and nucleotide analogues such as tenofovir and entecavir treat hepatitis B, but they do not act directly on hepatitis D.
Interferon can help move the virus into remission, but the person stays positive for hepatitis D RNA. A newer medicine, bulevirtide, blocks the receptor that hepatitis B and D use to enter liver cells. It is approved in Europe for adults with chronic hepatitis D, detectable HDV RNA, and compensated liver disease (a liver that is still working well enough to do its jobs). Your doctor can tell you which options fit your situation.
Doctors work with you to check hepatitis B and D markers, assess liver scarring, and watch for complications. Hepatitis D is linked to a higher risk of liver cancer, so regular surveillance matters. Finding the infection early allows timely staging and treatment, which may slow progression.
Liver transplant has been shown to be an effective treatment for fulminant acute and chronic hepatitis D.
Hepatitis D prevention is based on preventing hepatitis B. The hepatitis B vaccine prevents both infections.
How hepatitis D spreads
Hepatitis D can only develop in a person who already has hepatitis B. It is commonly spread through the skin or mucous membranes by contact with infected blood.
Men who have sex with men and healthcare workers are at high risk for hepatitis B but not for hepatitis D, though the reasons are unclear.
When to get checked
Hepatitis D can be suspected in anyone with hepatitis B, and it can cause rapid liver damage. Early testing allows timely staging and treatment, which may slow progression and reduce complications.
Talk to a healthcare provider about hepatitis D testing if you have hepatitis B. This matters most if you use drugs or have hemophilia, because hepatitis D is more common in these groups in the U.S.
If you already know you have hepatitis D, seek medical attention promptly for jaundice, dark urine, abdominal pain, or vomiting. Fulminant hepatitis is the most severe form of the disease.
A gastroenterologist or hepatologist can check your hepatitis B and D markers, assess liver scarring, watch for complications such as liver cancer, and discuss treatment options that fit your disease.
Find doctors who treat hepatitis D and connect with a liver specialist near you.
Eating & liver health
No diet treats hepatitis D, but food still matters because everything you eat passes through your liver. Hepatitis D can scar the liver quickly: 60% to 70% of people with chronic hepatitis D develop cirrhosis. Aim for a balanced diet that is low in fat, salt, and refined sugar.
Ask your doctor about alcohol, which can worsen liver damage from chronic viral hepatitis. If you have cirrhosis, do not cut back on protein or calories unless your doctor tells you to. Avoid uncooked shellfish such as oysters and clams.
Eat smaller meals every three to four hours. A light late-evening snack, with no more than 200 calories and 50 grams of carbohydrates, helps you avoid going without fuel overnight. Ask your liver specialist or a dietitian to build a plan with you.
Foods That Support Your Liver With Hepatitis D
Common questions
Hepatitis D is a liver infection caused by the hepatitis D virus (HDV), also called delta hepatitis. It can be acute (short-term) or chronic (long-lasting). The virus is "incomplete": it cannot make its own outer coat, so it needs the hepatitis B virus to multiply. For that reason, it can only infect people who already have hepatitis B, or who catch both viruses at the same time. Worldwide, more than 10 million people are infected.
No. There is no vaccine for hepatitis D. The hepatitis B vaccine prevents both infections, because hepatitis D cannot infect someone who does not have hepatitis B. Prevention of hepatitis D therefore rests on preventing hepatitis B. People who carry the hepatitis B virus should learn how it spreads, including through risky behaviors and from mother to child.
Not with a treatment made specifically for hepatitis D. Immunosuppressive therapy and antiviral drugs have shown no positive clinical effect, and hepatitis B medicines such as tenofovir and entecavir do not act directly on hepatitis D. Interferon can help move the virus into remission, but the person stays positive for hepatitis D RNA. Bulevirtide, a newer medicine, is approved in Europe for adults with chronic hepatitis D, detectable HDV RNA, and compensated liver disease. For severe disease, liver transplant has been shown to be an effective treatment. Your liver specialist can explain which options fit your situation.
Hepatitis D spreads through contact with infected blood, either through the skin or through mucous membranes. It can only develop in someone who already has hepatitis B. In the U.S., it is relatively uncommon, except among people who use drugs and people with hemophilia. Men who have sex with men and healthcare workers are at high risk for hepatitis B but not for hepatitis D, though the reasons are unclear.
Yes. Hepatitis D is considered the most aggressive form of viral hepatitis. People with chronic hepatitis D develop cirrhosis and its complications, including liver cancer, much faster than people with hepatitis B alone. Among people with chronic hepatitis D, 60% to 70% develop cirrhosis, which can occur about 2 years after the infection begins. The overall death rate is 2% to 20%, about ten times that of hepatitis B alone. Because of the higher cancer risk, regular surveillance for liver cancer matters.
Doctors start with a blood test for total antibodies to the hepatitis D virus. If it is positive, an HDV RNA test confirms that the virus is active. If HDV RNA stays detectable for more than 6 months, the infection is chronic. Doctors suspect hepatitis D in anyone who has hepatitis B, so ask about testing if you do. They also check hepatitis B markers and may assess liver scarring (fibrosis) to plan your care.
Medical disclaimer: LiverDirectory provides educational information and a directory of providers. It does not provide medical advice, diagnosis, or treatment. Always consult a licensed physician regarding any medical condition.
