Hepatitis D virus (HDV) cannot survive or replicate independently. Instead, HDV requires the outer shell of hepatitis B virus (HBV) to invade and damage liver cells. Dr. Doan Bich Hang, from the Department of Gastroenterology - Hepatobiliary - Pancreatic at Tam Anh General Hospital Hanoi, explained that patients co-infected with HDV-HBV face a higher risk of liver disease progression compared to those with HBV monoinfection.

When HDV enters liver cells, the immune system vigorously activates to control the virus. However, this excessive immune response simultaneously attacks liver cells, causing widespread necrosis. Some cases can lead to acute inflammation and acute liver failure in an already compromised liver. Prolonged or recurrent inflammation often transitions to a chronic stage.

Repeated or prolonged damage from hepatitis D virus hinders liver cell recovery. This leads to rapid, widespread destruction of liver cells. Persistent inflammation also rapidly replaces healthy liver tissue with fibrous tissue, causing the liver to gradually lose its regenerative capacity. This decline impairs vital functions such as: detoxification, protein synthesis, and metabolic regulation.

Hepatitis D virus testing at Tam Anh General Hospital. Photo: Hospital provided.

HDV-HBV co-infection causes severe liver damage, leading to complications such as: ascites, gastrointestinal hemorrhage, spontaneous bacterial peritonitis, or hepatic encephalopathy. Some patients may also experience acute liver failure in the context of chronic hepatitis, which is life-threatening.

According to Dr. Hang, hepatitis D virus also significantly increases the risk of hepatocellular carcinoma. Chronic inflammation, combined with ongoing liver cell damage and regeneration, creates a favorable environment for cellular transformation, promoting the formation of malignant cells.

In its early stage, hepatitis D virus symptoms are non-specific, including: fatigue, loss of appetite, and a heavy sensation in the upper right abdomen. Liver enzymes may be elevated but fluctuate erratically. In individuals already suffering from chronic hepatitis B, these signs are often mistaken for flare-ups of chronic hepatitis B virus, making diagnosis difficult.

Dr. Hang recommends that patients with chronic hepatitis B undergo regular monitoring, liver function tests, and screening for co-infecting viruses. Early detection of HDV and timely intervention can help improve liver health outcomes. Individuals not yet infected with hepatitis B virus can receive the hepatitis B vaccine to prevent the risk of contracting the disease.

Ly Nguyen