Does hepatitis D cause complications?

I was diagnosed with hepatitis D. Doctor, can this disease resolve on its own, and does it cause any concerning complications? (Phan Dat, 43 years old)

Hepatitis D virus (HDV) infection represents the most severe form of viral hepatitis in humans, posing significant risks for serious complications. HDV cannot cause illness independently; it only occurs in individuals already infected with acute or chronic hepatitis B virus (HBV). Patients can either be co-infected with hepatitis D and hepatitis B simultaneously, or acquire hepatitis D secondarily on a background of chronic hepatitis B, a condition known as superinfection.

When the hepatitis D virus enters the body, it aggressively attacks liver cells and triggers a strong inflammatory response. This can lead to rapid liver destruction and fibrosis. Patients are at risk of developing portal hypertension, esophageal and gastric varices, gastrointestinal bleeding, ascites, edema, and hepato-renal syndrome. Hepatitis D can also progress to acute liver failure or decompensated chronic liver failure, potentially resulting in hepatic encephalopathy, coagulopathy, and ascitic fluid infection.

Individuals infected with both hepatitis D and B viruses face a significantly higher risk of hepatocellular carcinoma compared to those with hepatitis B alone.

Dr. Thanh advises a patient. Illustration: Tam Anh General Hospital

Symptoms of hepatitis D typically emerge 3-7 weeks after infection. Common manifestations include fever, pain in the right hypochondrium, loss of appetite, nausea, dark urine, jaundice (yellowing of the skin and eyes), and general fatigue.

Patients diagnosed with hepatitis D should strictly adhere to their doctor's prescribed treatment regimen. While some cases of acute hepatitis D may resolve spontaneously, avoiding alcohol and maintaining a healthy lifestyle can support faster recovery. For those with chronic hepatitis D, doctors may prescribe antiviral drugs to control the virus by reducing HBsAg, an essential factor for HDV replication. Additionally, medications to decrease HDV RNA may be administered to improve liver function. Specific therapeutic approaches may vary depending on individual patient conditions.

Dr. Hoang Dinh Thanh, Specialist Level I

Department of Gastroenterology

Center for Endoscopy and Gastrointestinal Endoscopic Surgery

Tam Anh General Hospital, TP HCM

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