Dorothy FarrarHepatitis D
Hepatitis D is an inflammation of the liver and occurs mainly in southern Italy, Romania or Turkey. This infection is caused by the hepatitis D virus (HDV) exclusively in patients who are already infected with hepatitis B (HBV).
What is hepatitis D?
Hepatitis D (delta), an infection of the liver, is caused by viruses and is notifiable. It only occurs in conjunction with hepatitis B because the hepatitis D virus is “incomplete.” It does not have its own shell and needs the hepatitis B virus as a shell donor. When concomitant infection with hepatitis B and D occurs, this is called coinfection.
A superinfection is when the hepatitis D infection occurs after an already existing hepatitis B infection. A chronic hepatitis D, which lasts for several weeks, often leads to liver cirrhosis or even liver cancer, whereby healing is rarely possible.
Although it is estimated that “only” 30,000 people are infected with hepatitis D in Germany, more people die each year from this disease than from HIV-related diseases.
Causes
Like hepatitis B, hepatitis D is mainly transmitted during sexual intercourse (through sperm or blood) and through needles contaminated with infected blood, e.g. through drug abuse, tattooing or acupuncture. Patients can also become infected when transmitting contaminated blood.Transmission can occur through tear fluid, contact with mucous membranes, breast milk or minor injuries to the skin. Even during childbirth, the baby can be infected with hepatitis D.
Likewise, objects such as razors, nail or dental care of people possibly infected with hepatitis D can be cited as the cause of transmission of the virus.
When to see a doctor?
Anyone who feels the symptoms of hepatitis D infection after contact with foreign blood or sperm may have become infected and should have this clarified promptly. A typical sign of an infection is, for example, an increasing fatigue, which is usually associated with headaches, joint and muscle pain and loss of appetite. In the later course, fever, changes in stool color and consistency as well as symptoms of jaundice are added.
If these symptoms occur, a doctor should be consulted. Although the disease can only be treated symptomatically so far, early therapy is still essential to maintain quality of life. The symptoms mentioned usually become noticeable about three to seven weeks after infection. If there is already a concrete suspicion, for example through unprotected sexual intercourse, attention should be paid to complaints during this period. If symptoms actually occur, an immediate visit to the family doctor is recommended. The physician can specifically treat the symptoms and prevent an unwanted spread of hepatitis D through the diagnosis.
Symptoms and course
Typical signs of hepatitis D:
- dark urine
The incubation period of hepatitis D, i.e. the period from infection to the onset of the disease, can last 30 to 180 days. Hepatitis D has a similar course to hepatitis B, but is particularly aggressive. At the beginning of the infection, the patient suffers from symptoms such as loss of appetite and pain in the upper right abdomen . There is also nausea, diarrhea and fever. There is also muscle and joint pain.
As hepatitis D progresses, jaundice often develops, in which the patient’s skin, eyes and mucous membranes turn yellowish. That is why jaundice (icterus) is also spoken of here. Other symptoms of advanced hepatitis D include light-colored stools and dark-colored urine, which indicate liver damage.
When infected with hepatitis D and hepatitis B at the same time, the viruses prevent each other from multiplying. Although the course is usually severe, the risk of a chronic course of hepatitis D in the case of co-infection is relatively low, at a maximum of 10 percent.
However, infection with hepatitis D when hepatitis B is already present is much more dangerous than hepatitis B alone and also more serious than co-infection. This is because chronic liver inflammation develops in up to 9 percent of superinfections. And once chronic liver infection develops, chronic hepatitis B becomes worse. This in turn increases the risk of liver cirrhosis many times over.
Diagnosis
Hepatitis D is not easy to diagnose. If hepatitis D is suspected, the first step is to check whether the hepatitis B HBs antigen (HBsAg) is present. This is the envelope of the hepatitis B virus that the hepatitis D delta virus needs in order to multiply.
If HBsAg is detected, further tests are necessary to check whether hepatitis D has healed or is still present (PCR test for HDV RNA).
Complications
In most cases, hepatitis D can be cured. Complications usually only occur if the disease is not treated or is only treated late. Those affected primarily suffer from severe jaundice and general weakness. Severe fatigue and exhaustion are also not uncommon and can significantly reduce the patient’s quality of life. Those affected also experience a loss of appetite and pain in the abdomen and stomach. It is not uncommon for fever and pain in the extremities to occur.
The urine often turns dark, which can lead to a panic attack . Likewise, if left untreated, hepatitis D can lead to liver cancer, which can be fatal to the affected individual. Death also occurs when hepatitis B occurs in addition to hepatitis D. In the case of hepatitis D, only the symptoms can usually be limited. There are no particular complications. However, complete healing cannot be guaranteed. The life expectancy of those affected may also be reduced by hepatitis D.
treatment and therapy
Hepatitis D requires more complicated treatment than hepatitis B. The latter has been treated with the drug peginterferon alfa-2a for some time.
It is also possible to use peginterferon alfa-2a therapy for hepatitis D, which greatly reduces both hepatitis D and B viruses, but without actually curing the infection. After completion of therapy, the delta virus of hepatitis D often multiplies again.
Recently, a combination therapy of two active substances, consisting of Peg-interferon alfa and the active substance adefovir dipivoxil, has been used more promisingly. This therapy is now considered the standard therapy for treating hepatitis D because it is safe and effective. It seems that about a quarter of those infected with hepatitis D recover from the viral infection.The drug adefovir dipivoxil reduces the number of hepatitis B viruses and thus supports the healing of hepatitis B, which is present at the same time as hepatitis D. Patients are considered cured if the hepatitis B surface antigen HBsAg is no longer detectable in their blood, even months after the end of therapy.
Prevention
There is a vaccination against hepatitis B that also protects against hepatitis D. Other precautionary measures relate to sexual intercourse, in which condoms should be used with strangers or different partners.
Used syringes should never be reused, nor should nail or dental care items or razors be reused by people who may be infected with hepatitis D.
Hello and welcome to my Health Guide & Encyclopedia! My name is Dorothy Farrar, and I'm the founder and main author of this platform.
My passion for health and wellness started at a young age when I became interested in the connection between the food we eat and the way we feel. This fascination led me to study nutrition and dietetics in college, where I learned about the importance of a balanced diet and the impact of various nutrients on the body.