What is Hepatitis D?
Hepatitis D is a type of hepatitis that occurs due to infection with the hepatitis D virus (delta virus). This disease is also often called delta hepatitis. Just like other types of hepatitis, this disease is also characterized by inflammation of the liver.
This disease is more unique than other types of hepatitis. Because someone can only be infected if they have been infected with hepatitis B. Because HDV uses the hepatitis B virus to replicate.
Transmission can occur in two ways, namely simultaneously with Hepatitis B and Hepatitis D (co-infection). It can also be through a viral infection in an individual who has previously been infected with Hepatitis B (superinfection).
This disease is also divided into two types, namely acute and chronic. Acute Hepatitis D occurs suddenly with more severe symptoms. While the chronic type is an infection that occurs for 6 months or more, although the symptoms are not as severe as the acute type.
However, symptoms of chronic infection usually develop and worsen slowly. The virus that causes the disease usually remains in the body for several months before the first symptoms appear. The longer the infection occurs, the higher the risk of complications from the disease.
Symptoms of Hepatitis D
Most people do not experience symptoms of hepatitis D. However, people with acute disease may have the following symptoms:
- Fatigue.
- Loss of appetite.
- Pain in the upper right abdomen.
- Dark urine.
- Nauseous.
- Vomit.
- Yellowing of the skin and whites of the eyes ( jaundice ).
Meanwhile, people with chronic disease may not experience any symptoms even after years of being infected with the virus.
However, over time, they may notice symptoms of complications of the infection, such as severe damage to the liver.
- Signs and symptoms of liver damage include:
- Fatigue.
- Weight loss that you can’t explain.
- Weakness.
- Itchy skin.
- Swollen stomach.
- Swollen ankles.
- Yellowing of the skin and whites of the eyes.
Causes of Hepatitis D
The cause of hepatitis D is the HDV virus which infects the liver. This virus can be spread through bodily fluids or direct contact with those who already have it.
HDV can be transmitted through:
- Urine.
- Pregnancy (from mother to fetus).
- Delivery (from mother to baby).
- Semen fluid.
- Blood.
- Vaginal fluid.
Once infected with HDV, a person can transmit the virus to others, even before symptoms appear.
However, you can only get infected if you are already infected with hepatitis B. Because HDV uses the hepatitis B virus to replicate.
Hepatitis D Risk Factors
Some things that can cause someone to be more at risk of getting this disease include:
- Affected by hepatitis B infection.
- Frequently receiving blood transfusions.
- Having sex with people of the same sex, especially men.
- Drug abuse through injection needles.
- Dialysis patient.
- Healthcare facility workers.
Diagnosis of Hepatitis D
Doctors diagnose hepatitis D by evaluating your medical history, performing a physical exam, and blood tests.
If you have the disease, your medical professional may perform tests to check your liver.
Here are some initial diagnostic tests that a doctor can perform:
Health history
Your doctor will ask about your symptoms and factors that may make you more likely to get hepatitis D.
Physical examination
During a physical exam, your doctor will check for signs of liver damage such as changes in skin color, swelling in the lower legs, feet, or ankles, and tenderness or swelling in the abdomen.
To confirm the diagnosis of this disease, the doctor can perform the following types of examinations:
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Blood test
Your doctor may perform one or more blood tests to detect infection and the presence of anti-hepatitis D antibodies in your blood, which indicate that you are infected with the HDV virus.
In this examination, the doctor or medical officer will take a blood sample, then send it to the laboratory for further examination.
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Additional tests
If someone has chronic hepatitis D and B, the risk of liver damage increases. Your doctor may recommend tests to see if there is liver damage or how severe the liver damage is.
These tests may include:
- Blood test.
- Elastography, a special ultrasound that measures liver stiffness.
- Liver biopsy. In this test, your doctor uses a needle to remove a small piece of tissue from your liver. Then, a pathologist will examine the tissue under a microscope for signs of damage or disease.
Doctors usually use a liver biopsy only if other tests do not provide enough information about liver damage or disease.
Hepatitis D Treatment
Unfortunately, until now there is no specific medicine to treat hepatitis D. However, doctors will prescribe certain drugs to inhibit the development of the disease.
The following are treatments for hepatitis D that doctors can provide:
Anti virus
This drug works by increasing the body’s immune system, so that it can fight viruses and block viruses that try to damage the liver.
The antivirals that doctors usually prescribe are tenofovir, entecavir, and lamivudine.
Interferon drugs
This is a drug derived from a type of protein that is useful for suppressing the development of viruses and preventing the disease from getting worse.
Interferon medication administration depends on the patient’s condition, usually through IV injections and you must receive it every week for 1 year.
Liver Transplant
This procedure will be recommended by the doctor if the patient has experienced severe liver damage. Liver transplantation aims to replace the damaged liver with a new liver from a donor.
Complications of Hepatitis D
Acute hepatitis infection can damage the liver and can sometimes lead to acute liver failure, although this is rare.
Complications are more common in chronic hepatitis D, such as:
- Cirrhosis, scarring of the liver.
- Liver failure.
- Liver cancer.
Symptoms of these complications may include:
- Easy bleeding or bruising.
- Swollen feet or ankles due to water retention.
- Yellowing of the skin or eyes.
- Itchy rash.
- Weight loss without cause.
Prevention of Hepatitis D
If you do not have hepatitis B, you can prevent infection with this virus by taking steps to prevent hepatitis B infection, such as getting the hepatitis B vaccine.
By preventing hepatitis B, you are indirectly also preventing hepatitis D.
However, if you are already infected with hepatitis B, you can take steps to prevent hepatitis infection by:
- Do not share drug needles or other drug materials.
- Wear gloves if you have to touch someone else’s blood or an open wound.
- Do not share personal items such as toothbrushes, razors, or nail clippers.
- Have safe sex,
- Wash your hands regularly with soap and running water, especially after contact with blood.
- Undergo therapy or treatment for hepatitis B.
