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Hepatitis D

Hepatitis D is a disease caused by infection with hepatitis D virus (Delta virus). This virus causes inflammation of the liver.


Hepatitis D is a type of 5 types of hepatitis, namely hepatitis A, B, C, D and E. Each type of hepatitis has different methods and symptoms of multiplication. But specifically for hepatitis D, this disease requires the hepatitis B virus to infect liver cells. Transmission can occur in two ways: the first is a simultaneous infection with hepatitis B and hepatitis D (coinfection), and the second is infection with the hepatitis D virus in people who are already infected with hepatitis B (superinfection).

Hepatitis D can cause acute or chronic disease. Acute hepatitis D occurs suddenly and causes symptoms that are more severe than chronic hepatitis. If hepatitis D infection occurs for 6 months or more, then the infection that occurs is a chronic infection. In chronic infections, symptoms will appear and worsen slowly. Viruses usually remain in the body for several months before the first symptoms appear. The longer the hepatitis D infection lasts, the higher the risk of complications associated with this disease.

So far, there is no cure for the hepatitis D or hepatitis D. vaccine. However, the hepatitis B vaccine prevents this disease because the hepatitis D virus cannot cause infection only if there is hepatitis B.

Treatment for hepatitis D as early as possible can prevent the development of liver disorders in patients. Hepatitis D infection is important to detect because it can cause liver failure and a rapid decrease in cirrhosis and liver cancer, as well as increased mortality in adult patients.

Symptoms of hepatitis D

Hepatitis D infection is often asymptomatic in about 90% of people with this disease. In addition, hepatitis D virus infection is often difficult to distinguish from other hepatitis virus infections clinically, especially the symptoms of hepatitis B infection. Symptoms of hepatitis B and D are very similar, making it difficult to determine which viruses cause symptoms in patients. In some cases, hepatitis D can worsen the symptoms of hepatitis B. In addition, people with hepatitis B who have symptoms without symptoms can have symptoms of hepatitis B due to hepatitis D. Hepatitis D incubation, which is the time it takes for the virus to be exposed to symptoms, is around 21 up to 45 days. However, this can also occur more quickly, especially in the case of superinfection. Symptoms of hepatitis D that are often found include:

  • The skin and eyes turn yellow.
  • Feel tired.
  • Nausea and vomiting.
  • Joint pain
  • Stomach ache
  • Loss of appetite.
  • The color of urine becomes dark like tea.
  • itchy
  • It seems confused.
  • Bruised and bleeding.

Causes of hepatitis D

Hepatitis D is caused by infection with hepatitis D virus (HDV), which can be transmitted through bodily fluids or through direct contact with patients. HDV can be transmitted by:

  • Urine
  • Pregnancy (from mother to fetus).
  • Work (from mother to baby).
  • Sperm Fluid.
  • Vaginal discharge.
  • Blood

If someone has been infected with HDV, that person can transmit HDV to others, even before the onset of symptoms of hepatitis D. Among the factors that make a person more likely to get hepatitis D, pay attention:

  • Affected by hepatitis B.
  • Frequent blood transfusions.
  • Having the same sex, especially men.
  • Misuse of drugs through needles, such as heroin.
  • Dialysis patients.
  • Workers in health institutions.

Diagnosis of hepatitis D

To confirm the diagnosis of hepatitis D in patients, it is possible to carry out the following blood tests:

  • Antibody test. If anti-hepatitis D antibodies (IgM and anti-HDV IgG) are detected, the patient is positive for hepatitis D. Besides antibodies, the amount of virus in the blood (viral load) can be checked for the virus. hepatitis D, especially HDV RNA. But this test is rarely available. Remember that HDV infection can only occur together or after HBV infection. Therefore, an examination can also be done to detect hepatitis B in patients.
  • Liver function test. This test is to check the condition of the liver through blood samples. Based on test results, it is known whether there is interference or damage based on parameters examined in blood samples, including:
  1. Levels of protein in the blood (albumin).
  2. Liver enzyme levels (SGOT and SGPT).
  3. Bilirubin level.
  4. The state of blood coagulation (platelets and INR), given the liver-producing proteins that play an important role in blood clotting.
  • Ultrasound, CT scan, or these three scanning methods can be used to detect liver cancer, a complication of hepatitis D.
Treatment for hepatitis D

Until now, there is no satisfactory treatment for hepatitis D. Early diagnosis is very important to prevent liver damage. Alpha interferon is the only drug that has a therapeutic effect on this disease. Interferon treatment in patients is carried out every week by injection and can last 12 to 18 months. However, sometimes, after interferon treatment is completed, patients can still give positive results during HDV testing. The final approach to getting rid of hepatitis D is to get rid of hepatitis B. If hepatitis B is still positive, hepatitis D remains contagious.

Treatment of hepatitis D is focused on observing liver function. Especially for people with hepatitis D who have suffered liver damage due to cirrhosis or fibrosis, can undergo a liver transplant. This operation involves removing the damaged liver from the patient and replacing it with a healthy liver obtained from the donor.

Patients must always follow the routine examination program set by the doctor. The recommended control program is to monitor the course of hepatitis D and chronic hepatitis B at least every 6 months.

Complications of hepatitis D

Hepatitis D, if left untreated, can cause various complications that are dangerous for patients. Complications of hepatitis D tend to occur easily in patients with chronic hepatitis D compared with patients with acute hepatitis D. Some of the complications that may occur are:

  • Cirrhosis
  • Heart cancer.

Prevention of hepatitis D

The best way to prevent hepatitis D is to prevent the onset of hepatitis B. To prevent hepatitis B, preventive steps can be taken as follows:

  • Avoid drug use Avoid the use of illegal drugs, especially those that use syringes. Use sterile needles and never share them with needles.
  • Be careful when drilling and if you want to be pierced or tattooed, make sure the material is clean and sterile.
  • Use a condom. Always engage in safe and healthy sexual activity. Never have unprotected sex unless you think your partner is not infected with hepatitis or other sexually transmitted infections.
  • Has been vaccinated against hepatitis B. Children and adults who are at high risk of contracting hepatitis B must be vaccinated against hepatitis B.

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