How can you get infected with hepatitis D (HDV)?
The hepatitis B virus (HBV) and the hepatitis D virus (HDV) are mainly transmitted through blood, but can also be transmitted through other bodily fluids.
In Germany, the most common transmission routes for HBV and HDV infections are: unprotected sexual contact between one or more infected sexual partners; the sharing of hypodermic needles - namely among drug users - amongst one or more infected persons; and through the use of contaminated equipment used during tattooing, piercing or shaving.
HBV and HDV can also be transmitted during medical, surgical and dental procedures as a result of the reuse of contaminated material.
Mother-to-infant transmission of HBV and HDV is possible during childbirth.
Vaccination can safely prevent hepatitis B (HBV) and thus also hepatitis D (HDV).
If an individual knowingly becomes acutely infected with hepatitis B (HBV), it is recommended that the individual seek post-exposure prophylaxis, which is effective if administered within 48 hours of initial exposure.
Chronic HBV infection = increased risk of HDV infection
People with a chronic HBV infection have an increased risk of infection with the HDV virus.
Sources
Hepatitis D virus: an update. Pascarella S1, Negro F. Liver Int. 2011 Jan;31(1):7-21
Juhl D et al. Prevalence of antibodies against Hepatitis D virus (HDV) in blood donors in Northern Germany. Transfus Apher Sci. 2020 Jan 9:102721. doi: 10.1016/j.transci.2020.102721.
Robert Koch Institut. Epidemiologisches Bulleting Nr. 29. Virushepatitis B und D im Jahr 2018. https://www.rki.de/DE/Content/Infekt/EpidBull/Archiv/2019/Ausgaben/29_19.pdf?__blob=publicationFile. Juni 2020.
Website der WHO Stand 09/03/2020, verfügbar online unter: https://www.who.int/fr/news-room/fact-sheets/detail/hepatitis-d
Wedemeyer, H. & Manns, M. P. Nat. Rev. Gastroenterol. Hepatol. 7, 31–40 (2010); doi:10.1038/nrgastro.2009.205
Important stages from diagnosis to therapy
It is difficult to distinguish the symptoms of acute viral hepatitis D from another form of acute hepatitis.
If you have not been vaccinated against hepatitis B (HBV) and are at risk of contracting HBV or HDV , see your doctor for clarification and guidance. If you knowingly become acutely infected with hepatitis B (HBV), there is the possibility of post-exposure prophylaxis, which must be initiated within forty-eight hours
To find out whether you have contracted HBV or HDV, your blood will be tested in a laboratory.
If a HBV infection is confirmed, testing for hepatitis delta (HDV) should then take place immediately. Additionally, you should receive a referral to a liver specialist (hepato-gastroenterologist).
A hepatologist is a medicalspecialists for liver disease who will examine you in the hospital or in a doctor's office.
A HDV test should generally be performed in patients infected with HBV. More liver-specific tests can be done in the hospital.
Based on the results of the additional tests, your hepatologist, supported by a multidisciplinary medical team, will recommend and prescribe an appropriate HBV/HDV treatment.
Depending on the type of treatment prescribed, you will receive this directly at the hospital or you can obtain the medication from a pharmacy.
It is important to take your medication as directed and to read the patient information leaflets carefully.
Your hepatologist will monitor your treatment to check its effectiveness, as well as monitor the progression of the disease to detect any complications or signs of worsening.
Be assured that you are not alone on this journey or in dealing with this disease. It is very important to have someone to talk to. This can be a friend or family member. A patient organisation can also be a helpful contact point.