Signs of acute and chronic hepatitis D virus

MSc. Dinh Thi Huong, Department of Gastroenterology – Hepatobiliary – Pancreas, Tam Anh General Hospital, Hanoi, said that hepatitis D virus (HDV) only occurs in people infected with hepatitis B virus (HBV). Symptoms of hepatitis D virus depend on the form of infection: HBV – HDV coinfection or superinfection; acute or chronic phase.

Coinfection with HBV and HDV is when a patient is infected with both viruses at the same time in a person who has never had HBV. Superinfection means that a person with chronic HBV is then infected with HDV. This condition has the risk of leading to more severe chronic liver disease, progressing to cirrhosis and cancer.

Acute phase

HDV and HBV co-infection and superinfection all go through an acute phase. This stage usually lasts less than 6 months from exposure.

Common symptoms include mild fever, fatigue, loss of appetite, nausea, bloating, right upper quadrant pain, dark urine, jaundice, and yellow eyes. Some patients experience severe skin itching due to increased bilirubin. Symptoms often flare up suddenly and are more severe than simple acute hepatitis B.

Most patients recover on their own when the immune system eliminates the virus, but acute viral hepatitis D can progress to fulminant hepatitis, in high-risk groups such as people with pre-existing liver disease (chronic hepatitis B, cirrhosis), the elderly, immunocompromised, pregnant women, drinking a lot of alcohol… This condition causes massive liver necrosis in a short time, causing life-threatening acute liver failure if not treated promptly.

Chronic phase

Hepatitis D virus that lasts more than 6 months can potentially turn into a chronic stage. This is a dangerous stage because the liver is inflamed for a long time, damage accumulates quickly, and the risk of cirrhosis is higher than simple chronic hepatitis B virus infection.

According to Dr. Huong, many cases of chronic hepatitis D in the early stages have no symptoms or quite vague symptoms, such as persistent fatigue, poor appetite, bloating, indigestion, dull pain in the right lower quadrant, easily confused with digestive disorders, making diagnosis difficult. As the disease progresses, jaundice appears more clearly, itching, leg swelling or abdominal bloating gradually increases. Patients may have gastrointestinal bleeding due to esophageal and gastric varices (blood vomiting, black stools)…

Dr. Huong noted that hepatitis D virus often progresses silently, so many cases are detected late when the liver has been significantly damaged. Meanwhile, if detected promptly and diagnosed early, the disease can be closely monitored and controlled to help reduce the risk of complications.

People infected with hepatitis B virus need to be screened for hepatitis D virus early and at least once in their life. To prevent hepatitis D, doctors recommend that everyone get vaccinated against the disease. HDV is transmitted in the same ways as HBV, including blood, sexual, and from mother to child, so you should have safe sex and use condoms; Do not share needles, razors, or toothbrushes. Limit alcohol and fatty foods to reduce the burden on the liver.