Hepatitis D

Causes of Hepatitis D

The disease is caused by the hepatitis D virus—a small virus with a defective structure that requires the envelope of the hepatitis B virus to replicate. Infection occurs either simultaneously with both viruses or in a patient who is already a carrier of hepatitis B. In such cases, the disease progresses more aggressively and often develops into a chronic form. The infection typically occurs when the virus enters the bloodstream through skin injuries or mucous membranes.

Prevalence and Geographical Distribution

Hepatitis D is found in many countries, with the highest incidence recorded in the Mediterranean region, some parts of Asia, Africa, South America, and Eastern Europe. In Russia, cases are more frequently registered in the southern regions, but the infection is also found in other parts of the country. In recent years, thanks to preventive measures, the prevalence of the virus has gradually decreased, although complete control of the disease has not yet been achieved.

Transmission of Hepatitis D

Hepatitis D virus is typically transmitted when the virus enters the bloodstream from an external source. This can happen, for example, during medical procedures if sterility rules are not followed. In some cases, the infection can be transmitted from mother to child during childbirth. Transmission is also possible through close household contact, especially in families where there is already a patient with chronic hepatitis B.

Symptoms and Signs of Hepatitis D

The symptoms of hepatitis D are similar to those of other viral liver infections:

• Elevated body temperature;

• Pain in the liver area;

• Weakness, fatigue;

• Nausea, loss of appetite;

• Dark urine and pale stools;

• Yellowing of the skin and the whites of the eyes.

The disease can progress in either an acute or chronic form. In some cases, symptoms develop rapidly, and the patient’s condition deteriorates sharply.

The MARUS platform helps patients with hepatitis D organize treatment at leading clinics in Russia. We select specialized doctors and provide support at all stages—from the initial consultation to the completion of therapy. With MARUS, patients can focus on their health without spending time searching for doctors or dealing with organizational issues.

Diagnosis of Hepatitis D

Diagnosis includes a combination of laboratory and instrumental methods. The doctor typically prescribes:

• Blood test for antibodies to HDV and viral RNA;

• Liver biochemical markers (ALT, AST, bilirubin);

• Liver ultrasound to assess organ structure;

• PCR to determine the activity of the virus.

Timely diagnosis helps detect the disease early and begin treatment before serious complications develop.

Treatment of Hepatitis D

Treatment of hepatitis D in Russia is conducted according to modern protocols. The only drug with proven effectiveness is pegylated interferon alpha. Therapy lasts at least 48 weeks. In recent years, bulevirtide (Myrcludex) has been introduced into clinical practice, showing good results and offering new opportunities for patients with chronic forms of the disease.

Treatment includes:

• Prescription of antiviral drugs;

• Supportive therapy to protect the liver;

• Monitoring of viral activity;

• Regular follow-up with the doctor.

Treatment for hepatitis D is available at both federal and private clinics in Russia. In some cases, treatment is possible under the compulsory medical insurance (OMS) policy in Moscow and other cities.

The effectiveness of therapy depends on the stage of the disease, the patient’s condition, and adherence to medical recommendations. With the right approach, it is possible to reduce viral load and stabilize the patient’s condition. 

Prognosis and Consequences

With timely diagnosis and active treatment, the prognosis improves, although complete cure is not always achievable today. Without therapy, there is a high risk of developing severe complications:

• Liver cirrhosis;

• Liver failure;

• Hepatocellular carcinoma.

Modern methods can significantly slow disease progression and improve the patient’s quality of life.

Prevention of Hepatitis D

The main prevention strategy is to avoid infection with the hepatitis B virus, as HDV cannot cause disease on its own. Important preventive measures include:

• Vaccination against hepatitis B;

• Use of sterile medical instruments;

• Avoidance of sharing needles and syringes;

• Safe sexual practices.

Regular medical check-ups and diagnostics help to detect the infection early and start treatment promptly.

Risk Groups and Predisposing Factors

The highest risk of hepatitis D infection is among patients with chronic hepatitis B, since HDV only develops in the presence of an existing infection. Risk groups include people who use injectable drugs and medical personnel who handle blood as part of their work. There is also an increased risk among patients who receive regular blood transfusions and those living with hepatitis virus carriers. Significant risk factors also include frequent changes of sexual partners and neglect of personal hygiene rules.

When to See a Doctor

A medical consultation is necessary if the following symptoms appear:

• Persistent high fever;

• Pain in the liver area;

• Yellowing of the skin and mucous membranes;

• General weakness and loss of appetite.

For patients with chronic hepatitis B, it is important to undergo regular testing for HDV, even in the absence of symptoms.

Recommendations for Rehabilitation After Treatment

After completing therapy, patients are advised to follow a balanced diet, completely eliminate alcohol, and limit heavy physical activity. It is important to continue taking liver-supporting medications as prescribed and to attend regular follow-up appointments. Rehabilitation helps restore liver function and prevent complications. For one year after treatment, it is necessary to monitor biochemical markers and viral load.

Hepatitis D Vaccination

There is no specific vaccine against HDV. The primary preventive measure is vaccination against hepatitis B. Protection against the HBV virus automatically eliminates the risk of contracting hepatitis D.

Hepatitis B vaccination is included in the national immunization schedule and is administered from an early age. Booster vaccinations are recommended for adults in high-risk groups.