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Hepatitis D

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

Hepatitis D is one type of 5 types of hepatitis, namely hepatitis A, B, C, D and E. Each type of hepatitis has different methods of spread and symptoms. But specifically for hepatitis D, this disease requires the Hepatitis B virus to infect liver cells. Transmission can be reached in two ways, the first is simultaneous infection with Hepatitis B with Hepatitis D (co-infection), and the second is Hepatitis D virus infection in individuals who have been infected with previous Hepatitis B (superinfection).

Hepatitis D can cause acute or chronic diseases. Acute hepatitis D occurs suddenly and causes more severe symptoms than chronic hepatitis D. If hepatitis D infection occurs for 6 months or more, then the infection that occurs is a chronic infection. In chronic infections, symptoms that arise will develop and get worse slowly. Viruses usually stay in the body for several months before the first symptoms appear. The longer the hepatitis D infection occurs, the higher the risk of complications due to this disease.

Until now, there is no known cure for hepatitis D or vaccines to prevent hepatitis D. However, this disease can be prevented by hepatitis B vaccine because the Hepatitis D virus can only cause infection if there is a Hepatitis B.

Treatment of hepatitis D as early as possible can prevent the occurrence of liver failure in sufferers. Hepatitis D infection is important because it can cause liver failure and rapid deterioration in the direction of cirrhosis and liver cancer, as well as increased mortality in adult patients.

Symptoms of Hepatitis D

Hepatitis D infection is often asymptomatic (causes no symptoms) in about 90% of sufferers. In addition, hepatitis D infection is often difficult to distinguish from other hepatitis virus infections clinically, especially symptoms of hepatitis B virus infection. Symptoms of hepatitis B and D are very similar, making it difficult to determine which virus causes symptoms in patients. In some cases, hepatitis D can make hepatitis B symptoms worse. In addition, people with hepatitis B with asymptomatic symptoms can experience symptoms of hepatitis B due to hepatitis D. The incubation period for hepatitis D, which is the time needed for the virus to be exposed to symptoms, is around 21-45 days. However, it can also take place faster, especially in superinfection. Symptoms of hepatitis D commonly encountered include:

  • The skin and eyes turn yellow.
  • Fatigue.
  • Nausea and vomiting.
  • Joint pain.
  • Abdominal pain
  • Loss of appetite.
  • The color of the urine turns dark like tea.
  • Itchy.
  • Looks confused
  • Bruising and bleeding.

Causes of Hepatitis D

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




  • Urine.
  • Pregnancy (from mother to fetus).
  • Labor (from mother to baby).
  • Sperm liquid.
  • Vaginal fluid.
  • Blood.

 

If someone has been infected with HDV, that person can transmit HDV to others, even before symptoms of hepatitis D appear. Some things that make a person more susceptible to hepatitis D include:

  • Affected by hepatitis B. infection
  • Often receive blood transfusions.
  • Having same-sex sex, especially men.
  • Drug abuse through needles, such as heroin.
  • Dialysis patients.
  • Health facility workers.

Diagnosis of Hepatitis D

To ensure the diagnosis of hepatitis D in patients, can be done by blood tests as follows:

Antibody Examination. If anti-hepatitis D antibodies (IgM and IgG anti-HDV) are found, the patient is positive for hepatitis D. In addition to antibodies, the number of viruses in the blood (viral load) can be examined for hepatitis D, HDV RNA. But this examination is rarely available. Keep in mind that HDV infection can only occur together or after HBV infection occurs. Therefore, an examination can also be performed to detect hepatitis B in patients.

Liver Function Examination. This test aims to check the condition of the liver organ through a blood sample. From the results of the test, it is known whether it is experiencing interference or damage based on the parameters examined in the blood sample, including:

  • Levels of protein in the blood (albumin).
  • Liver enzyme levels (SGOT and SGPT).
  • Bilirubin levels.
  • Blood clotting status (Thrombocytes and INR), considering the liver producing proteins that are important in blood clotting.

Ultrasound, CT scan or These three scanning methods can be used to detect liver cancer which is a complication of hepatitis D.

Hepatitis D treatment

Until now there has been no satisfactory treatment for hepatitis D. Early diagnosis is very important to prevent liver damage. Interferon-alpha is the only drug that shows the therapeutic effect on this disease. Treatment using interferon in patients is done by injection every week and can last for 12-18 months. However, sometimes after interferon treatment is completed, patients can still give positive results on testing the HDV virus. The final approach to eliminating hepatitis D is to eliminate hepatitis B. If hepatitis B is still positive, hepatitis D is still infectious.

Hepatitis D treatment focuses on observing liver function checks. Especially for people with hepatitis D who have suffered liver damage due to cirrhosis or fibrosis, can undergo liver transplant surgery. This operation is carried out by lifting the patient's damaged liver and replacing it with a healthy liver obtained from a donor.

Patients must always undergo a routine control program scheduled by a doctor. The recommended control program is at least every 6 months to monitor the development of hepatitis D infection and also chronic hepatitis B.

Hepatitis D Complications

If not handled properly, hepatitis D can cause various complications that harm the patient. Complications of hepatitis D tend to occur easily in patients with chronic hepatitis D compared to patients with acute hepatitis D. Some complications that may occur are:

  • Cirrhosis.
  • Heart cancer.

Prevention of Hepatitis D

The best way to prevent hepatitis D is to prevent the occurrence of hepatitis B. To avoid hepatitis B, preventive measures can be carried out as follows:

  • Avoid using drugs Avoid using illegal drugs, especially those using syringes. Use sterile needles and never share using needles.
  • Be more careful in piercing and if you intend to be pierced or tattooed, make sure the equipment is clean and sterile.
  • Use condoms. Always do sexual activity safely and healthily. Never have sex without using a condom unless you believe your partner is not infected with hepatitis or other sexually transmitted infections
  • Underwent hepatitis B vaccination. Children and adults who have a high risk of developing hepatitis B must undergo hepatitis B vaccination.



References

References

World Health Organization (2018). Hepatitis D.

Rizzetto, M. (2015). Hepatitis D Virus: Introduction and Epidemiology. Cold Spring Harbor Perspectives in Medicine.

Noureddin, et al. (2014). Hepatitis Delta: Epidemiology, Diagnosis and Management 36 Years After Discovery. Current Gastroenterology Reports.


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Is a health and wellness enthusiast. In him free time, she loves to travel and taste different types of teas.

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