Hepatitis D

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Hepatitis D virus infection could causes acute or chronic infection.

 

Transmission

The mode of transmission is like Hepatitis B virus.

It only infect patients who have infection with hepatitis B.

It is common in Mediterranean countries, Asia and Africa

Incubation period

Incubation period- 2 to 8 weeks.

 

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Clinical Presentations

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Acute infection

Commonly seen in co-infected patients (infection with HBV and HDV at the same time).

These patients have high rate of fulminant hepatitis.

The clearance rate is high.

 

Chronic infection

Chronic infection is common in patients who have super-infection.

The clearance rate is very low.

Significant number of these patients may progress to develop cirrhosis and hepatocellular carcinoma

 

Investigation

LFT- transaminase increase four to five fold.

Biopsy- fibrosis and necrosis

 

Diagnostic tests

Serum specimen- HBsAg if positive do Hepatitis D Ag, Hepatitis D IgM and IgG

Hepatitis D

 

Co-infection                 +                          +/+                          +                +                  

Super-infection             +                         -/+                            +                +

 

 

Screening tests

Infection with hepatitis D virus is uncommon in the UK and screening is not routinely done.

 

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Treatment

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Low protein diet is advised.

Avoid alcohol

Acute infection- high proportion will resolve without therapy

Chronic infection- interferon therapy.

 

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Prevention

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Screening of blood for transfusion and organ before transplantation are effective.

Vaccination with Hepatitis B vaccine is effective to prevent infection with HDV.

After exposure to HDV, vaccination with HB vaccine and HB specific immunoglobulin are considered to be effective to prevent infection with HDV.

 

 

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