Premium Nahrungsergänzungsmittel | artgerecht

Hepatitis D – Causes, Symptoms and Treatment

Hepatitis D is a liver disease caused by the hepatitis D virus (HDV), which can only occur in people already infected with hepatitis B. It may take an acute or chronic course.

Regular tips about health Regular tips about health

Things worth knowing about "Hepatitis D"

Hepatitis D is a liver disease caused by the hepatitis D virus (HDV), which can only occur in people already infected with hepatitis B. It may take an acute or chronic course.

What is Hepatitis D?

Hepatitis D (also known as delta hepatitis) is an inflammation of the liver caused by the hepatitis D virus (HDV). A unique characteristic of this virus is that it can only survive and replicate in the presence of the hepatitis B virus (HBV), making HDV a so-called satellite virus. Infection with HDV occurs either simultaneously with an HBV infection (coinfection) or as an additional infection in a person who already has chronic hepatitis B (superinfection).

Causes and Transmission

The hepatitis D virus is primarily transmitted through direct contact with infected blood. The most common routes of transmission include:

Sharing needles or syringes (intravenous drug use)
Unprotected sexual intercourse
Mother-to-child transmission during childbirth
Contact with infected blood or blood products

Since HDV depends entirely on HBV, only individuals who are already infected with hepatitis B or who become co-infected simultaneously are at risk.

Forms of Hepatitis D Infection

Coinfection

A coinfection occurs when both HBV and HDV are transmitted at the same time. In most cases, this form resolves on its own, but it can occasionally lead to a severe acute course.

Superinfection

A superinfection occurs when a person who already has chronic hepatitis B additionally acquires HDV. This form frequently leads to a chronic course and carries a significantly higher risk of serious liver disease.

Symptoms

The symptoms of hepatitis D are similar to those of other forms of hepatitis and may include:

Fatigue and general exhaustion
Jaundice (icterus) – yellowing of the skin and eyes
Dark urine and pale stools
Nausea, vomiting, and loss of appetite
Upper abdominal pain (especially in the liver area)
Joint pain

In some cases, the infection may initially cause few or no symptoms. Chronic cases can lead to liver cirrhosis or hepatocellular carcinoma over the long term.

Diagnosis

The diagnosis of hepatitis D is established through blood tests. The following parameters are examined:

Anti-HDV antibodies: Detection of a current or past infection
HDV RNA: Direct detection of the virus using a PCR test (indicates active viral replication)
HBsAg: Confirmation of concurrent hepatitis B infection
Liver enzymes (e.g., ALT, AST) to assess liver damage
Liver ultrasound if structural changes are suspected

Treatment

Treatment of hepatitis D is more challenging than that of other hepatitis types, as HDV depends on HBV for its replication. Available treatment options include:

Pegylated interferon-alpha: The previous standard of care, which can inhibit viral replication, although complete viral clearance is achieved in only a minority of patients.
Bulevirtide (Hepcludex): A novel entry inhibitor approved in the EU since 2020 specifically for the treatment of chronic hepatitis D. It blocks the entry of both HDV and HBV into liver cells.
Treatment of the underlying hepatitis B, as effective suppression of HBV also limits HDV replication.

Prevention

Since HDV can only exist alongside HBV, vaccination against hepatitis B effectively protects against hepatitis D as well. For individuals already living with hepatitis B, the following protective measures are important:

Avoiding shared needles or syringes
Using barrier protection during sexual activity
Education about transmission routes

References

World Health Organization (WHO): Hepatitis D Fact Sheet. Available at: https://www.who.int/news-room/fact-sheets/detail/hepatitis-d (2023)
European Association for the Study of the Liver (EASL): EASL Clinical Practice Guidelines on hepatitis delta virus infection. Journal of Hepatology, 77(3), 799-814 (2023)
Terrault N.A. et al.: Hepatitis D – Current and Emerging Therapies. Hepatology, 75(4), 1027-1041 (2022)

Building Blocks for a Healthy Life

As an integrated manufacturer, we develop & produce evidence-based, patented, and non-patented formulations. We work exclusively with plant and natural extracts according to the strictest purity & quality standards.
The combination of science & modern technology with the laws of nature creates solutions consistently tailored to humans – for the highest good: health.