Hepatitis D (patient information): Difference between revisions
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{{Hepatitis D (patient information)}} | {{Hepatitis D (patient information)}} | ||
{{CMG}} | {{CMG}}; {{AE}} {{JS}} | ||
==Overview== | ==Overview== | ||
Also known as "[[delta hepatitis]]," is a serious [[liver disease]] caused by [[infection]] with the [[Hepatitis D virus]] ([[HDV]]), which is an [[RNA virus]] structurally unrelated to the [[Hepatitis A]], [[Hepatitis B|B]], or [[Hepatitis C|C]] viruses. [[Hepatitis D]], which can be acute or chronic, is uncommon in the United States. [[HDV]] is an incomplete virus that requires the helper function of [[Hepatitis B virus]] to replicate and only occurs among people who are [[infected]] with the [[Hepatitis B virus]] ([[HBV]]). Common [[symptoms]] include: [[abdominal pain]], [[nausea]], [[vomiting]], [[jaundice]] and [[loss of appetite]]. [[HDV]] is transmitted through [[percutaneous]] or [[mucosal]] contact with [[infectious]] blood and can be acquired either as a [[coinfection]] with [[HBV]] or as superinfection in persons with [[HBV]] infection. There is no [[vaccine]] for [[Hepatitis D]], but it can be prevented in persons who are not already [[HBV]]-infected by Hepatitis B [[vaccination]]. Possible complications include: severe acute and chronic [[hepatitis]], [[cirrhosis]] and [[hepatocellular carcinoma]]. | |||
==What are the symptoms of Hepatitis D?== | ==What are the symptoms of Hepatitis D?== | ||
Hepatitis D may make the symptoms of hepatitis B more severe. | Hepatitis D may make the [[symptoms]] of [[hepatitis B]] more severe. | ||
Symptoms may include: | [[Symptoms]] may include: | ||
* Abdominal pain | * [[Abdominal pain]] | ||
* Dark | * [[Dark urine]] | ||
* Fatigue | * [[Fatigue]] | ||
* Jaundice | * [[Jaundice]] | ||
* Joint pain | * [[Joint pain]] | ||
* Loss of appetite | * [[Loss of appetite]] | ||
* Nausea | * [[Nausea]] | ||
* Vomiting | * [[Vomiting]] | ||
Exams and Tests | Exams and Tests | ||
* Anti-delta agent antibody | * Anti-delta agent [[antibody]] | ||
* Liver biopsy | * [[Liver biopsy]] | ||
* Liver enzymes (blood test) | * [[Liver enzymes]] (blood test) | ||
==What causes Hepatitis D?== | ==What causes Hepatitis D?== | ||
Hepatitis D virus (HDV) is only found in people who carry the hepatitis B virus. HDV may make a recent (acute) hepatitis B infection or an existing long-term (chronic) hepatitis B liver disease worse. It can even cause symptoms in people who carry hepatitis B virus but who never had symptoms. Hepatitis D | [[Hepatitis D]] or [[delta hepatitis]] is caused by the [[hepatitis delta virus]] ([[HDV]]), a defective [[RNA virus]]. [[HDV]] requires the help of a virus like the [[hepatitis B virus]] ([[HBV]]) for its own replication. | ||
Risk factors include: | [[Hepatitis D virus]] ([[HDV]]) is only found in people who carry the [[hepatitis B virus]]. [[HDV]] may make a recent (acute) [[hepatitis B]] infection or an existing long-term (chronic) hepatitis B liver disease worse. It can even cause [[symptoms]] in people who carry [[hepatitis B virus]] but who never had symptoms. Hepatitis D occurs in 5% of people who carry hepatitis B. | ||
* | |||
[[Risk factors]] include: | |||
* Using intravenous (IV) or injection drugs | |||
* Being infected while pregnant (the mother can pass the virus to the baby) | * Being infected while pregnant (the mother can pass the virus to the baby) | ||
* Carrying the hepatitis B virus | * Carrying the [[hepatitis B virus]] | ||
* Men having sexual intercourse with other men | * Men having sexual intercourse with other men | ||
* Receiving many blood transfusions | * Receiving many [[blood transfusions]] | ||
===Transmission=== | |||
[[Transmission]] is similar to that of [[HBV]]: | |||
* Bloodborne and sexual | |||
* Percutaneous (injecting drug use, haemophiliacs) | |||
* Permucosal (sexual) | |||
* Rare perinatal | |||
[[HDV]] is transmitted [[percutaneously]] or sexually through contact with [[infected]] [[blood]] or blood products. | |||
[[Blood]] is potentially [[infectious]] during all phases of active hepatitis D infection. Peak [[infectivity]] probably occurs just before the onset of acute disease. | |||
==Who is at highest risk?== | ==Who is at highest risk?== | ||
Risk factors include | [[Risk factors]] include: | ||
* | * Chronic [[Hepatitis B Virus]] carriers are at risk for [[infection]] with [[HDV]] | ||
* Using [[intravenous]] (IV) or injection drugs | |||
* Being infected while pregnant (the mother can pass the virus to the baby) | * Being infected while pregnant (the mother can pass the virus to the baby) | ||
* Carrying the hepatitis B virus | * Carrying the [[hepatitis B virus]] | ||
* Men having sexual intercourse with other men | * Men having sexual intercourse with other men | ||
* Receiving many blood transfusions | * Receiving many [[blood transfusions]] | ||
* People exposed to unscreened [[blood]] or [[blood]] products | |||
* [[Haemophilia|Haemophiliacs]] | |||
Since [[HDV]] absolutely requires the support of [[hepatitis B virus]] for its own replication, inoculation with [[HDV]] in the absence of [[HBV]] will not cause hepatitis D. Alone, the [[viral]] [[genome]] indeed replicates in a helper-independent manner, but virus particles are not released | |||
Individuals who are not infected with [[HBV]], and have not been [[vaccine|immunized]] against [[HBV]], are at risk of infection with [[HBV]] with simultaneous or subsequent infection with [[HDV]]. | |||
==When to seek urgent medical care?== | ==When to seek urgent medical care?== | ||
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==Diagnosis== | ==Diagnosis== | ||
*Anti-delta agent antibody | The [[diagnosis]] of acute [[hepatitis D]] is made after evaluation of [[serologic]] tests for the [[virus]]. Total anti-[[HDV]] are detected by commercially available [[radioimmunoassay]] (RIA) or [[enzyme immunoassay]] (EIA) kits. | ||
*Liver biopsy | |||
*Liver enzymes (blood test) | The method of choice for the [[diagnosis]] of ongoing [[HDV]] infection should be [[RT-PCR]]. | ||
Other tests that help in the diagnosis of hepatitis D include: | |||
*Anti-delta agent [[antibody]] | |||
*[[Liver biopsy]] | |||
*[[Liver enzymes]] (blood test) | |||
==Treatment options== | ==Treatment options== | ||
Currently there is no treatment for [[hepatitis D]]. | |||
Disease conditions may occasionally improve with administration of a-interferon (a vaccine administrated during 12 months) | |||
Since no effective [[antiviral]] therapy is currently available for treatment of type D hepatitis, [[liver transplantation]] may be considered for cases of fulminant acute and end-stage chronic hepatitis D. | |||
A [[liver transplant]] for end-stage chronic hepatitis B may be effective. | |||
==Where to find medical care for Hepatitis D?== | ==Where to find medical care for Hepatitis D?== | ||
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==What to expect (Outlook/Prognosis)?== | ==What to expect (Outlook/Prognosis)?== | ||
Persons with an acute HDV infection usually get better over 2 to 3 weeks. Liver enzyme levels return to normal within 16 weeks. About 10% of those who are infected may develop long-term (chronic) liver inflammation (hepatitis). | Persons with an acute [[HDV]] [[infection]] usually get better over 2 to 3 weeks. | ||
[[Liver enzyme]] levels return to normal within 16 weeks. | |||
About 10% of those who are infected may develop long-term (chronic) liver inflammation (hepatitis). | |||
==Possible complications== | ==Possible complications== | ||
* | Possible [[complications]] of [[hepatitis D]] include: | ||
* Fulminant hepatitis | * Active [[chronic hepatitis]] | ||
* Fulminant [[acute hepatitis]] | |||
* [[Cirrhosis]] | |||
* [[Hepatocellular carcinoma]] | |||
==Prevention== | ==Prevention== | ||
Prompt diagnosis and treatment of hepatitis B infection can help prevent hepatitis D. | Since [[HDV]] is dependent on [[HBV]] for replication, control of [[HDV]] infection is achieved by targeting [[HBV]] infections. All measures aimed at preventing the [[transmission]] of [[HBV]] will prevent the [[transmission]] of [[hepatitis D]]. | ||
No [[vaccines]] exist against [[HDV]]; however, [[vaccination]] against [[HBV]] of patients who are not chronic [[HBV]] carriers, provides protection against [[HDV]] infection. | |||
However, there is no effective measure to prevent [[HDV]] infection of chronic [[HBV]] carriers, and prevention of [[HBV]]-[[HDV]] [[superinfection]] can only be achieved through education to reduce risk behaviors. | |||
Prompt [[diagnosis]] and treatment of [[hepatitis B]] infection can help prevent hepatitis D. | |||
Avoidance of [[intravenous]] drug abuse. If you use IV drugs, avoid sharing needles. | |||
==Alternative Names== | ==Alternative Names== | ||
| Line 70: | Line 114: | ||
==Sources== | ==Sources== | ||
http://www.nlm.nih.gov/medlineplus/ency/article/000216.htm | http://www.nlm.nih.gov/medlineplus/ency/article/000216.htm<br> | ||
[http://www.who.int/en/ World Health Organization] | |||
{{WS}}{{WH}} | {{WS}}{{WH}} | ||
[[Category:Patient information]] | [[Category:Patient information]] | ||
[[Category:Medicine]] | |||
[[Category:Infectious disease patient information]] | |||
[[Category:Gastroenterology]] | |||
[[Category:Hepatology]] | |||
[[Category:Hepatitis]] | |||
[[Category:Viral diseases]] | |||
[[Category:Gastroenterology patient information]] | |||
[[Category:Disease]] | |||
[[Category:Dermatology]] | |||
[[Category:Emergency mdicine]] | |||
[[Category:Up-To-Date]] | |||
[[Category:Infectious disease]] | |||
Latest revision as of 22:06, 29 July 2020
For the WikiDoc page for this topic, click here
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Hepatitis D |
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Hepatitis D On the Web |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]
Overview
Also known as "delta hepatitis," is a serious liver disease caused by infection with the Hepatitis D virus (HDV), which is an RNA virus structurally unrelated to the Hepatitis A, B, or C viruses. Hepatitis D, which can be acute or chronic, is uncommon in the United States. HDV is an incomplete virus that requires the helper function of Hepatitis B virus to replicate and only occurs among people who are infected with the Hepatitis B virus (HBV). Common symptoms include: abdominal pain, nausea, vomiting, jaundice and loss of appetite. HDV is transmitted through percutaneous or mucosal contact with infectious blood and can be acquired either as a coinfection with HBV or as superinfection in persons with HBV infection. There is no vaccine for Hepatitis D, but it can be prevented in persons who are not already HBV-infected by Hepatitis B vaccination. Possible complications include: severe acute and chronic hepatitis, cirrhosis and hepatocellular carcinoma.
What are the symptoms of Hepatitis D?
Hepatitis D may make the symptoms of hepatitis B more severe. Symptoms may include:
Exams and Tests
- Anti-delta agent antibody
- Liver biopsy
- Liver enzymes (blood test)
What causes Hepatitis D?
Hepatitis D or delta hepatitis is caused by the hepatitis delta virus (HDV), a defective RNA virus. HDV requires the help of a virus like the hepatitis B virus (HBV) for its own replication. Hepatitis D virus (HDV) is only found in people who carry the hepatitis B virus. HDV may make a recent (acute) hepatitis B infection or an existing long-term (chronic) hepatitis B liver disease worse. It can even cause symptoms in people who carry hepatitis B virus but who never had symptoms. Hepatitis D occurs in 5% of people who carry hepatitis B.
Risk factors include:
- Using intravenous (IV) or injection drugs
- Being infected while pregnant (the mother can pass the virus to the baby)
- Carrying the hepatitis B virus
- Men having sexual intercourse with other men
- Receiving many blood transfusions
Transmission
Transmission is similar to that of HBV:
- Bloodborne and sexual
- Percutaneous (injecting drug use, haemophiliacs)
- Permucosal (sexual)
- Rare perinatal
HDV is transmitted percutaneously or sexually through contact with infected blood or blood products.
Blood is potentially infectious during all phases of active hepatitis D infection. Peak infectivity probably occurs just before the onset of acute disease.
Who is at highest risk?
Risk factors include:
- Chronic Hepatitis B Virus carriers are at risk for infection with HDV
- Using intravenous (IV) or injection drugs
- Being infected while pregnant (the mother can pass the virus to the baby)
- Carrying the hepatitis B virus
- Men having sexual intercourse with other men
- Receiving many blood transfusions
- People exposed to unscreened blood or blood products
- Haemophiliacs
Since HDV absolutely requires the support of hepatitis B virus for its own replication, inoculation with HDV in the absence of HBV will not cause hepatitis D. Alone, the viral genome indeed replicates in a helper-independent manner, but virus particles are not released
Individuals who are not infected with HBV, and have not been immunized against HBV, are at risk of infection with HBV with simultaneous or subsequent infection with HDV.
When to seek urgent medical care?
Call for an appointment with your health care provider if you have symptoms of hepatitis B.
Diagnosis
The diagnosis of acute hepatitis D is made after evaluation of serologic tests for the virus. Total anti-HDV are detected by commercially available radioimmunoassay (RIA) or enzyme immunoassay (EIA) kits.
The method of choice for the diagnosis of ongoing HDV infection should be RT-PCR.
Other tests that help in the diagnosis of hepatitis D include:
- Anti-delta agent antibody
- Liver biopsy
- Liver enzymes (blood test)
Treatment options
Currently there is no treatment for hepatitis D.
Disease conditions may occasionally improve with administration of a-interferon (a vaccine administrated during 12 months)
Since no effective antiviral therapy is currently available for treatment of type D hepatitis, liver transplantation may be considered for cases of fulminant acute and end-stage chronic hepatitis D.
A liver transplant for end-stage chronic hepatitis B may be effective.
Where to find medical care for Hepatitis D?
Directions to Hospitals Treating Hepatitis D
What to expect (Outlook/Prognosis)?
Persons with an acute HDV infection usually get better over 2 to 3 weeks.
Liver enzyme levels return to normal within 16 weeks.
About 10% of those who are infected may develop long-term (chronic) liver inflammation (hepatitis).
Possible complications
Possible complications of hepatitis D include:
- Active chronic hepatitis
- Fulminant acute hepatitis
- Cirrhosis
- Hepatocellular carcinoma
Prevention
Since HDV is dependent on HBV for replication, control of HDV infection is achieved by targeting HBV infections. All measures aimed at preventing the transmission of HBV will prevent the transmission of hepatitis D.
No vaccines exist against HDV; however, vaccination against HBV of patients who are not chronic HBV carriers, provides protection against HDV infection.
However, there is no effective measure to prevent HDV infection of chronic HBV carriers, and prevention of HBV-HDV superinfection can only be achieved through education to reduce risk behaviors.
Prompt diagnosis and treatment of hepatitis B infection can help prevent hepatitis D.
Avoidance of intravenous drug abuse. If you use IV drugs, avoid sharing needles.
Alternative Names
Hepatitis D virus
Sources
http://www.nlm.nih.gov/medlineplus/ency/article/000216.htm
World Health Organization