Hepatitis D Questions and Answers for the Public

• What is hepatitis D?
• What is hepatitis B/hepatitis D coinfection?
• What is hepatitis D superinfection?
• How common is hepatitis D in the United States?
• Where is hepatitis D most common?
• How is hepatitis D spread?
• Besides contact with blood and body fluids from an infected person, are there other ways I could get hepatitis D?
• Who is at risk for hepatitis D?
• Am I at risk for hepatitis D if I was vaccinated against hepatitis B?
• Who is more likely to have long-term health problems, like progressive liver damage, following hepatitis D virus infection?
• What are the signs and symptoms of hepatitis D?
• Are the symptoms of coinfection different than symptoms of superinfection?
• How do I find out if I’m infected with the hepatitis D virus?
• How is hepatitis D treated?
• How can I prevent hepatitis D?

What is hepatitis D?
Hepatitis D is a liver infection caused by the hepatitis D virus. Only people infected with the hepatitis B virus can get hepatitis D. They can become infected with both viruses at the same time (known as “coinfection”) or get hepatitis D after first being infected with hepatitis B virus (known as “superinfection”). Hepatitis D can cause severe symptoms and serious illness that can lead to life-long liver damage and even death.

What is hepatitis B/hepatitis D coinfection?
People who get infected with both hepatitis B and hepatitis D at the same time are considered to be coinfected. Coinfection with hepatitis B and hepatitis D can cause serious, short-term health problems and even liver failure, but it usually does not lead to life-long illness.

What is hepatitis D superinfection?
Superinfection happens when people get hepatitis D after having been first infected with the hepatitis B virus. This type of infection is more likely to result in long-term illness, including rapid development of liver fibrosis, liver failure, and even death.

How common is hepatitis D in the United States?
Hepatitis D is considered to be uncommon in the United States. However, the number of people with hepatitis D is unknown, because this infection is not tracked by public health departments or by CDC.

Where is hepatitis D most common?
Hepatitis D is most common in Eastern Europe, Southern Europe, the Mediterranean region, the Middle East, West and Central Africa, East Asia, and the Amazon Basin in South America.

How is hepatitis D spread?
You can only get hepatitis D after coming into contact with the blood or body fluids of someone who is infected with the hepatitis D virus. This can happen through

• having sex with an infected person
• sharing needles, syringes, or any other equipment used to prepare or inject drugs
• birth to an infected mother (although this is rare)
• contact with blood from the open sores of an infected person
• needle sticks or exposures to sharp instruments
• sharing personal items (e.g., razors and toothbrushes) that may have come in contact with an infected persons blood.

Besides contact with blood and body fluids from an infected person, are there other ways I could get hepatitis D?
No. The hepatitis D virus is not spread through food or water, sharing eating utensils, breastfeeding, hugging, kissing, hand holding, coughing, or sneezing.

Who is at risk for hepatitis D?
People at risk for hepatitis D are also at risk for hepatitis B. You may be at increased risk if you are

• infected with the hepatitis B virus
• an injection-drug user
• a sex partner of someone infected with the hepatitis B virus and/or hepatitis D virus
• coinfected with HIV and the hepatitis B virus
• a man who has sex with men

Am I at risk for hepatitis D if I was vaccinated against hepatitis B?
No. People who get the hepatitis B vaccine are also protected against hepatitis D.

Who is more likely to have long-term health problems, like progressive liver damage, following hepatitis D virus infection?
People who get hepatitis D after being infected with the hepatitis B virus (“superinfection”) are much more likely to experience liver damage, and even death, from their infection than those who get both infections at the same time (“coinfection”).

What are the signs and symptoms of hepatitis D?
People with hepatitis D can have more severe symptoms than those who are infected with hepatitis B alone. The signs and symptoms of hepatitis D usually appear 3–7 weeks after infection with the hepatitis D virus. They include:

• Fever
• Fatigue
• Loss of appetite
• Nausea
• Vomiting
• Abdominal pain
• Dark urine
• Clay-colored stool
• Joint pain
• Jaundice

Are the symptoms of coinfection different than symptoms of superinfection?
Yes. People who get infected with both viruses at the same time (“coinfection”) can have distinct sets of symptoms during two separate time periods. This happens because symptoms of hepatitis B may occur at a different time than those of hepatitis D. People who get hepatitis D after first being infected with the hepatitis B virus (“superinfection”) usually experience rapid and severe symptoms. This type of infection can lead to serious long-term health outcomes, like liver disease and death.

How do I find out if I’m infected with the hepatitis D virus?
If you are experiencing symptoms of hepatitis D, visit your health-care provider. A blood test is needed to detect infection with the virus that causes hepatitis D.

How is hepatitis D treated?
A prescription medication called interferon can help some patients, and new treatments are being studied. People with end-stage liver disease as a result of hepatitis D may need a liver transplant.

How can I prevent hepatitis D?
To prevent hepatitis D, you can get vaccinated against hepatitis B. Although no vaccine is available for hepatitis D, getting the hepatitis B vaccine also protects you from hepatitis D.