Hepatitis D Virus
Hepatitis D (HDV) is a viral infection that only infects individuals who are also infected with Hepatitis B virus. Approximately 5% of those with Hepatitis B also have Hepatitis D.
How can you get it?
Hepatitis D is transmitted just as Hepatitis B, through contact with the blood or body fluids of a person infected with HDV. The risk factors are similar:
- Exposure to blood through a needle stick or cut from sharp instrument
- Contact with blood or open sores of an infected patient to mucous membranes or broken skin
- Sharing personal care items with an infected person (ex. razors, toothbrushes)
- Injection Drug Use, Sexual Activity, Mother-to-Child
HDV presents in two different forms:
- Co-infection Infection with HDV and HBV at the same time
- Superinfection Infection with HBV first, then later infection with HDV
Symptoms
HDV can worsen an acute or chronic Hepatitis B infection. The signs and symptoms of Hepatitis D may include:
- Fatigue
- Yellowing of the skin and eyes (called jaundice)
- Abdominal pain
- Nausea and/or vomiting
The symptoms typically last 2 to 3 weeks but complications of HDV infection include chronic liver inflammation in 10% of those infected. Complete liver failure may also occur. Those who experience a co-infection with HBV are likely to recover while those with a superinfection are more likely to develop chronic infection and liver failure.
Prevention
The best way to prevent Hepatitis D is to be vaccinated against Hepatitis B. You can help prevent the spread of HDV by following a comprehensive OSHA required program for Bloodborne pathogen exposures which includes the following:
- Getting vaccinated against Hepatitis B
- Prompt treatment of any Hepatitis B infection
- Sharps Safety
- Training and consistent use of safer needle techniques and devices
- Proper sharp disposal
- Using Universal Precautions
- Hand hygiene (wash with soap and water or using an alcohol based hand rub)
- Personal protective equipment (PPE) (gloves, gowns, masks and goggles that offer mouth, nose and eye protection)
- Proper handling and disposal of instruments/devices and clothing contaminated with blood or body fluids.
What should you do if you are exposed to the disease or get the disease?
Immediately following an exposure:
- Wash needlesticks and cuts with soap and water
- Flush splashes to the nose, mouth, or skin with water
- Irrigate eyes with clean water, saline, or sterile solutions
As soon as possible, report the exposure and seek medical care:
- Determining Hepatitis B status is important since the bloodborne pathogen hepatitis D is an incomplete virus that requires Hepatitis B infection.
- If you are exposed to Hepatitis B, it is an OSHA requirement that you are offered an evaluation for bloodborne pathogen exposure.
- This will include having blood drawn as soon as possible to determine your baseline serologic status. This test determines if you have protective antibodies.
- If you do not have protective antibodies to Hepatitis B, your healthcare provider may decide to give you the vaccine and/or Hepatitis B Immune Globulin (HBIG) for immediate protection.
The medication alpha interferon has been used to manage some of the inflammation but there is no cure for Hepatitis D. Since Hepatitis D can be acquired following infection with Hepatitis B, those infected with Hepatitis B should protect their liver from further damage, by getting immunized for Hepatitis A, avoiding alcohol, avoiding risk factors listed above and having continuing medical care.