Hepatitis D (Delta)

Hepatitis D (Delta

2006

Delta hepatitis is an infection and inflammation of the liver caused by the hepatitis D virus . It is one of several types of hepatitis . The hepatitis D virus (also called delta virus ) is a small circular RNA virus . The hepatitis D virus is replication defective and therefore cannot reproduce in the absence of another virus . In humans , hepatitis D virus infection only occurs in the presence of hepatitis B infection . In 1977 , a previously unrecognized nuclear antigen was detected in hepatocytes of patients with chronic hepatitis B

. The antigen resembled hepatitis B core antigen (HBcAg ) in its subcellular localization . Its presence was always associated with hepatitis B virus (HBV ) infection but it rarely co-existed with HBcAg . It was termed "delta antigen Patients with delta antigen develop anti-delta antibodies . In 1980 , the delta antigen was recognized to be the component of a novel virus that was defective and required coinfection with HBV to reproduce . The hepatitis delta virus (HDV ) was shown to rely on HBV for transmission because it used the hepatitis B surface antigen (HBsAg ) as its own virion coat . The virus like delta agent was subsequently shown to be associated with the most severe forms of acute and chronic hepatitis in many HBsAg-positive patients . Hepatitis D or delta hepatitis is caused by the hepatitis delta virus (HDV , a defective RNA virus . HDV requires the help of a hepadnavirus like hepatitis B virus (HBV ) to reproduce Delta hepatitis is an infection of humans . The viruses have been found in blood , saliva , semen , and vaginal secretions of infected individuals Acute delta hepatitis infection may be followed by recovery but usually becomes chronic and causes symptoms for years . An infected person with no symptoms can still spread delta hepatitis to others . They can be spread through sexual contact with an infected person , passed on to a newborn from an infected mother during childbirth , or transmitted by contact with infected blood or bodily fluids . Routes of transmission of hepatitis D are similar to those of hepatitis B . For this reason , it is seen in individuals who have received a blood transfusion or who have shared needles during drug abuse . Chronic liver disease , which may occur with hepatitis D , often has minimal symptoms . At times there may be mild flare-ups with jaundice (yellowing of the skin and whites of the eyes accompanied by darkened urine , nausea , fatigue , and weight loss Symptoms that are similar to hepatitis B but there are those with no symptoms at all . Hepatitis D virus infection is often severe if it occurs in someone who already has chronic hepatitis B . This acute fulminant form of hepatitis involves severe liver cell destruction and loss of liver function . It can be fatal . Symptoms include : an enlarged painful liver , enlarged spleen , severe jaundice , susceptibility to bleeding , encephalopathy - a dis in the functioning of the brain aplastic anemia in rare cases . Aplastic anemia is a condition in which the bone marrow cannot make enough red and white blood cells . Chronic HBV carriers are at risk for infection with HDV , especially as they participate in activities which put them at risk of repeated exposure to hepatitis D (e .g , intravenous drug abuse , and unsafe sex , especially among homosexuals . Individuals who are not infected with HBV , and have not been immunized against HBV , are at risk of infection with HBV with simultaneous or subsequent infection with HDV . Since HDV absolutely requires the support of a hepadnavirus to reproduce itself , inoculations with HDV in the absence of HBV will not cause hepatitis D . Alone , the viral genome indeed replicates in a helper-independent manner , but virus particles are not released . The healthcare provider may suspect hepatitis D after doing a physical examination and checking liver function tests . Another blood test , often drawn at the same time as the liver function tests , can confirm that hepatitis D is the cause of the symptoms . Chronic hepatitis can be diagnosed with a liver biopsy . Liver biopsy specimens can be graded in terms of severity . Liver biopsies may have to be done repeatedly to detect progression of the disease or response to therapy . There are no special medicines or antibiotics that can be used to treat individuals with hepatitis D . Hepatitis D is a viral disease , and as such , antibiotics are of no value in the treatment of the infection . There is no hyperimmune D globulin available for pre- or postexposure prophylaxis . Disease conditions may occasionally improve with administration of the antiviral drug alpha interferon , which can help if not that fatal . It is more effective in the early stage of the disease . Some people with severe hepatitis or end-stage liver disease may need a liver transplant , it can reappear in the transplanted liver but it is rare . The hepatitis delta virus is present worldwide and in all age groups . Its distribution parallels that of HBV infection although with different rates (highest in parts of Russia , Romania Southern Italy and the Mediterranean countries , Africa and South America . In some HBV-prevalent countries such as China , HDV infection is disproportionately low . Delta hepatitis is rare in the U .S Washington State averages less than one case a year . Since delta hepatitis is dependent on hepatitis B infection , preventing hepatitis B infections will prevent delta hepatitis infections . Vaccinating people against hepatitis B can do this or by reducing transmission of hepatitis B . Infected persons can prevent the spread of delta hepatitis by not sharing any blood testing devices , needles , or other drug equipment . No donating of blood or organs , no sharing of razors , toothbrushes , nail care devices , or any other personal items that might have their blood on them . Let health care professionals who may be exposed to their blood know that they have delta hepatitis . Recommend that any regular sexual partner be vaccinated for hepatitis B . Although sexual transmission appears to be low , inform sexual partners that you have delta hepatitis and consider using condoms and barriers . Cover cuts or open sores on skin

There is no special medicine for HDV , but living a clean and healthy life makes a person disease free

REFERENCE

M .D . Achord , J . L (2002 . Understanding Hepatitis ' Mississippi University Press of Mississippi PAGE 2

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HEPATITIS D (DELTA ...