Hepatitis is the inflammation of the liver, which typically occurs as a result of a viral infection. There are five main types of hepatitis, which are called hepatitis A, B, C, D, and E. Each type of hepatitis has different causes.

People can get hepatitis D through direct with the bodily fluids of someone with the infection. However, they can only get hepatitis D if they already have a hepatitis B infection.

In this article, learn more about hepatitis D, including the causes, symptoms, and treatment options.

a tired woman with Hepatitis D
A person with hepatitis D may experience fatigue, loss of appetite, and nausea.

Hepatitis D, which people sometimes call delta hepatitis, is a viral infection that occurs due to the hepatitis D virus (HDV) and causes inflammation of the liver.

According to the , 5% of people across the world with chronic hepatitis B also have hepatitis D. This percentage equates to about 15–20 million people.

Rates of reported hepatitis D are highest across:

  • Africa
  • Asia
  • Eastern Europe
  • Middle East
  • South America
  • Pacific Islands
  • Greenland

Hepatitis D is not very common in the United States, where there are fewer than reported cases of the virus. The success of the hepatitis B vaccine, which also prevents hepatitis D, means that rates of HDV have decreased around the globe since the .

People may develop acute hepatitis D, chronic hepatitis D, or both.

People with acute hepatitis D may have the following symptoms:

  • fatigue
  • loss of appetite
  • pain in the upper right abdomen, over the liver
  • dark urine
  • lighter stools
  • nausea
  • vomiting
  • yellowing of the skin and whites of the eyes (jaundice)

People with chronic hepatitis D may not notice any symptoms even after years of living with the virus.

Over time, however, they may notice symptoms from complications of the infection, such as severe damage to the liver. Signs and symptoms of liver damage include:

  • fatigue
  • unexplained weight loss
  • weakness
  • itchy skin
  • a swollen abdomen
  • swollen ankles
  • yellowing of the skin and whites of the eyes

A person with a chronic hepatitis D infection may experience chronic itching and unexplained weight loss.

Acute hepatitis D infections can damage the liver, and they can sometimes cause acute liver failure, although this is rare.

Chronic hepatitis D infections can cause:

Symptoms of these complications can include:

  • easily bleeding or bruising
  • swollen legs or ankles due to water retention
  • yellowing of the skin or eyes
  • intense itching
  • unexplained weight loss

Treatment for complications involves taking antiviral medicine, which works to prevent the virus from further damaging the liver. Avoiding alcohol and maintaining a healthful lifestyle can also help limit the damage.

If chronic hepatitis D causes liver cancer, treatment may include:

  • radiation therapy to kill cancerous cells
  • surgery to remove the cancerous part of the liver
  • immunotherapy to help the immune system fight cancer cells
  • chemotherapy
  • liver transplantation

Early diagnosis of liver cancer increases the likelihood of successful treatment.

If people have liver failure, it means that the liver is unable to function properly, and they will need a liver transplant.

Early treatment of hepatitis D and B helps lower the risk of getting complications from the infections.