Hepatitis D

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Hepatitis D
Hepatitis D

Video: Hepatitis D

Video: Hepatitis D
Video: Hepatitis B and hepatitis D virus- causes, symptoms, diagnosis, treatment, pathology 2024, March
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Hepatitis D

In delta hepatitis, hepatitis D viruses (HDV) cause (diffuse) inflammation of the liver tissue throughout the organ. HDV is a defective RNA virus that attaches to liver cells with preference and that depends on the helper function of the hepatitis B virus. Hepatitis D viruses are only infectious and capable of multiplying in a person who is positive for hepatitis B. The course of acute hepatitis B becomes more complicated and protracted by HDV. In the case of co-infection (simultaneous infection) with hepatitis B and D viruses, however, a chronic course of hepatitis B develops less frequently 90 percent of the cases lead to a chronic course of hepatitis D.

The illness is notifiable. Although basically every patient with hepatitis B is at the risk of HDV infection, there are significant differences in the global occurrence between HBV and HDV.

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  • Advice, downloads & tools
  • Global spread of hepatitis D
  • How is hepatitis D transmitted?
  • How can hepatitis D be prevented?
  • How does hepatitis D work?
  • How is the diagnosis made?
  • How is hepatitis D treated?
  • How to prevent hepatitis D.
  • Who can I turn to? ">Whom can I ask?

Who can I turn to? >

  • How will the costs be reimbursed?
  • Who can I turn to? >

    Global spread of hepatitis D

    Hepatitis D is an often underestimated global health problem. Around the world, around ten to 15 million people are infected with HDV. Hepatitis D infection is particularly common in the Mediterranean region, the Middle East, North and Central Asia, Vietnam, the Pacific Islands, West and Central Africa and South America.

    How is hepatitis D transmitted?

    The infection is mainly transmitted through blood or sexual intercourse. Saliva and tear fluid are also less infectious. In Western and Central Europe, migrants from endemic regions (regions with many sick people) and drug users who inject themselves drugs are particularly affected. Transmission from mother to child can occur in very rare cases. This risk of transmission is particularly increased if the mother is also highly infected with hepatitis B (high hepatitis B viral load, positive HBe antigen) at the time of the child's birth.

    Transmission of hepatitis D is mainly possible

    • if the sexual partner has hepatitis D,
    • through "needle sharing" (shared use of syringes among drug addicts),
    • at birth, if the mother has hepatitis D, or
    • from a needlestick injury if a person with hepatitis D is involved.

    Additional possibilities of infection arise from the shared use of the toothbrush or the razor of a person with hepatitis D or from tattoos and piercings under unsanitary conditions. So-called nosocomial transmission cases in healthcare facilities are extremely rare. Transmission through blood and blood products is prevented in Austria by the precautionary checking of these products for HDV.

    How can hepatitis D be prevented?

    A reliable protection against hepatitis D can be achieved above all by the hepatitis B vaccination. Further preventive measures include avoiding blood contact, performing tattoos and piercings in a sterile manner, using only toothbrushes, razor blades, needles or syringes (no needle sharing) and safer sex (condoms).

    How does hepatitis D work?

    Like acute hepatitis B, acute hepatitis D can develop without symptoms. Usually, however, nausea, fatigue, fever and possibly jaundice (jaundice) occur.

    Two forms of infection can occur:

    • The acute co-infection with hepatitis B and D virus at the same time. In 95 percent, both infections heal, but fulminant courses with acute liver failure occur more frequently than with single infections with hepatitis B. It is therefore recommended that all patients with acute hepatitis B be tested for the simultaneous presence of acute hepatitis D.. If this is confirmed, then close monitoring is necessary. Chronic courses are rare (around two percent), but can occur more frequently in patients with immune deficiencies (e.g. HIV infections, immunosuppressive drug therapy), which is why this group of patients should definitely be vaccinated against hepatitis B.
    • The HDV superinfection in patients with hepatitis B infection. A significantly more severe course of the liver disease occurs more frequently than in people with hepatitis B infection alone. In these cases, hepatitis D becomes chronic in 70 to 90 percent. The development of liver cirrhosis progresses much more rapidly (within five to ten years after HDV infection), as does the development of liver cancer.

    How is the diagnosis made?

    Sometimes during the physical examination the doctor can detect signs of inflammation of the liver - e.g. enlarged liver, jaundice (jaundice) - or their consequences - e.g. ascites. However, hepatitis D can only be diagnosed by detecting virus components or antibodies against the virus in the blood.

    In laboratory diagnostics, the determination of HDV antigen and anti-HDV using ELISA is important in addition to the detection of the HDV genome, the polymerase chain reaction (PCR). Regardless of whether co-infection or super-infection, a clear increase in GOT or GPT can be determined in both cases. However, the level of the liver values does not allow any conclusions to be drawn about the extent of liver cell death.

    How is hepatitis D treated?

    There is no specific treatment for acute hepatitis D, only the symptoms can be influenced. In many cases, the course of chronic hepatitis D can be positively influenced by interferon (pegylated interferon alpha 2a) and leads to permanent elimination of the hepatitis D virus in around 25 percent of cases. The accompanying hepatitis B should always be treated optimally. Liver transplantation is a therapeutic option for patients with cirrhosis of the liver caused by hepatitis B / D virus. As with chronic hepatitis B, regular check-ups are necessary.

    How to prevent hepatitis D

    A reliable protection against hepatitis D can be achieved above all by the hepatitis B vaccination. Further preventive measures include avoiding blood contact, performing tattoos and piercings in a sterile manner, using only toothbrushes, razor blades, needles or syringes (no needle sharing) and safer sex (condoms).

    Whom can I ask?

    Diagnosis and treatment of hepatitis D are possible in the following facilities:

    • special hospital outpatient department, e.g. hepatological outpatient department;
    • Cash outpatient clinics with special hepatology clinics;
    • In the private practice area: Specialists in internal medicine with in-depth hepatological knowledge.
    • Severe forms of illness are treated in a department for internal medicine (focus on gastroenterology and hepatology) or in a department for transplant surgery.

    How will the costs be reimbursed?

    All necessary and appropriate diagnostic and therapeutic measures are taken over by the health insurance carriers. You can find more information under What does a hospital stay cost? Your resident doctor or outpatient clinic will generally settle accounts directly with your health insurance provider. With certain health insurance providers, however, you may have to pay a deductible (treatment contribution) (BVAEB, SVS, SVS, BVAEB). However, you can also use a doctor of your choice (ie doctor without a health insurance contract). For more information, see What does a hospital stay cost, a doctor's visit: Costs and deductibles.

    For certain non-drug treatments (e.g. physical therapy) - in some cases only when a certain level has been reached - approval from the health insurance provider may be required.

    For certain services (e.g. medical aids and medical aids) - depending on the health insurance provider - patient co-payments are provided. Most health insurance providers provide for a permit, sometimes depending on the type of medical aid. The prescription fee has to be paid for medication on a “prescription”. For more information about the respective provisions, please contact your health insurance provider, which you can find on the social security website, for example.

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