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HDV at a glance

The role of the liver:

The liver is the central metabolic organ in the body and is multifunctional. The liver functions as: an energy store; a detoxification station; a conversion station for nutrients; control centre for sugar and hormone levels in the blood; and a production site for blood components. It is important to keep the liver healthy and to help it continue to do its job when it is weak.

What is Hepatitis Delta?

Hepatitis D (HDV) is a viral disease of the liver and can take an acute or chronic course. It is important to know that you can only become infected with the hepatitis D virus (HDV) in the presence of the hepatitis B virus (HBV).

wo ways an infection can be distinguished:

  • Simultaneous infection: an infection with HBV and HDV occurs at the same time
  • Superinfection: infection with HBV occurs followed by infection with HDV*

Routes of transmission

There are three main transmission routes:

  1. Transmission at birth from mother to child
  2. Transmission through infected blood (blood transfusions), and/or by sharing: acupuncture needles and syringes, sharp or sharp-edged objects for example:tattoo, piercing implements, hygiene items such as toothbrushes and razors, drug set such as syringes, sneeze tubes etc
  3. Sexual transmission (if the sexual partner is infected with HDV) HDV and HBV have the same transmission paths. In Western Europe, approximately 5-12% of people with chronic HBV infection are also infected with HDV.*

Testing and diagnosis

Hepatitis D (HDV) can only be diagnosed by detecting virus components or antibodies. For this, blood must be taken from the patient r, which is examined in the laboratory. If the antibody test is positive, a second test is then carried out, the PCR test.*

Testing is recommended if there is an existing HBV infection or if there is potential transmission from a HDV carrier.

Tips for a healthy liver

  • A healthy and balanced diet (little sweet, fatty and salty)
  • Regular physical activity
  • Avoidance of alcohol and tobacco
  • Avoidance of such activities which may lead to obesity

Protection against infection

If you know the transmission paths, you can protect yourself from infection.

The HBV vaccination offers protection against infection.

Symptoms

Similar to HBV infection, HDV infection is usually asymptomatic. Possible symptoms of acute HDV infection include:

  • tiredness
  • fever
  • jaundice (icterus)
  • loss of appetite
  • nausea

Possible symptoms of chronic HDV infection include:

  • feeling sick
  • loss of appetite
  • fatigue
  • feeling of pressure in the upper right abdomen
  • dark urine and light-coloured stools
  • jaundice (icterus)

Consequences of untreated HDV virus infection and the importance of monitoring treatment*

Hepatitis means inflammation of the liver cells. If HDV is not detected and treated, the live will be continually exposed to this inflammation. The body’s initial response to this is  to  build functionless connective tissue in the liver. This increased formation of connective tissue is called fibrosis. As the inflammatory process progresses, more and more liver cells die, leaving behind scar tissue known as cirrhosis. In advanced liver cirrhosis, the liver can no longer do its job sufficiently which leads to  further health complications which can result in  liver failure. Cirrhosis also increases the risk of liver cancer.
In order to counteract severe incidences of the disease, it is important to identify HDV at an early stage, to treat it and to monitor treatment.

Sources:

AWMF-Register-Nr.: 021/011 Prophylaxis, Diagnosis and Therapy of Hepatitis B Virus Infection – The German Guideline; 880 ** Clinical features of hepatitis D. Farci P1, Niro GA. Semin Liver Dis. 2021 Aug; 32(3):228-36eitig

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