Hepatitis D history and symptoms
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Hepatitis D |
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Diagnosis |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Varun Kumar, M.B.B.S. [2]; João André Alves Silva, M.D. [3] Jolanta Marszalek, M.D. [4]
Overview
Hepatitis D can only occur in patients who are simultaneously (coinfection) or previously (superinfection) infected with HBV. Common symptoms of hepatitis D include: fever; yellowish discoloration of the eyes and skin; fatigue; abdominal pain; loss of appetite; nausea; vomiting; and dark urine. Coinfection is associated with a more severe form of the disease, often leading to fulminant hepatitis. In superinfection, symptoms may be unspecific initially, and the majority of these cases progress into chronicity.[1][2]
History
Part of the initial evaluation for HDV infection includes a thorough patient history focusing on potential modes and timing of infection. Aspects covered in the patient's history include:[3]
- Exposure to blood and/or blood products
- Injection drug use(IDU)
- Sexual exposure
- Occupational exposure
- Recent history of invasive procedures performed in non-hospital health care settings, including hemodialysis centers and long-term care facilities[4]
Chronic HDV
In chronic HDV, history taking includes obtaining information regarding factors associated with the progression of liver disease.[5] The following aspects should be covered:[5][3]
- Risk factors for coinfection with HDV, HCV, and HIV
- Family history of liver disease and HCC
- Medication history
- Smoking status
- Alcohol consumption
- Drug abuse
- Sexual activity
- Antiretroviral drug regimen if coinfected with HIV(to assess potential for treatment resistance)
Symptoms of hepatitis D are similar to those of hepatitis B. Simultaneous infection with HBV and HDV (coinfection) often courses with a severe acute form of the disease, usually with ab abrupt onset of symptoms.[1]
Symptoms
Simultaneous infection with HDV and HBV (coinfection) is associated with a more severe form of the disease, often leading to fulminant hepatitis. In the case of infection with HDV, in a previously HBsAg positive patient (superinfection), symptoms may be unspecific initially. In this last case, the disease often tends to chronicity. Common symptoms of both forms of the disease include:[1][2]
- Fever
- Yellowish discoloration of the eyes and skin
- Fatigue
- Abdominal pain
- Loss of appetite
- Nausea
- Vomiting
- Joint pain
- Muscle pain
- Dark (tea colored) urine
- Clay-colored stools
- Skin rash
References
- ↑ 1.0 1.1 1.2 Heidrich B, Manns MP, Wedemeyer H (2013). "Treatment options for hepatitis delta virus infection". Curr Infect Dis Rep. 15 (1): 31–8. doi:10.1007/s11908-012-0307-z. PMID 23242761.
- ↑ 2.0 2.1 "Hepatitis D".
- ↑ 3.0 3.1 Rotman Y, Brown TA, Hoofnagle JH (2009). "Evaluation of the patient with hepatitis B." Hepatology. 49 (5 Suppl): S22–7. doi:10.1002/hep.22976. PMC 2881483. PMID 19399815.
- ↑ Thompson ND, Perz JF, Moorman AC, Holmberg SD (2009). "Nonhospital health care-associated hepatitis B and C virus transmission: United States, 1998-2008". Ann Intern Med. 150 (1): 33–9. PMID 19124818.
- ↑ 5.0 5.1 Lok AS, McMahon BJ (2009). "Chronic hepatitis B: update 2009". Hepatology. 50 (3): 661–2. doi:10.1002/hep.23190. PMID 19714720.