Hepatitis D
Key points
- Hepatitis D is a form of viral hepatitis that causes inflammation to the liver
- It only happens in people who also have hepatitis B
- You get it through contact with body fluids
- Hepatitis D can be prevented by being vaccinated for hepatitis B
- Anyone with hepatitis B should also get tested for hepatitis D
What is hepatitis D?
Hepatitis D, also known as HDV or Delta hepatitis, is a form of viral hepatitis. You can only get hepatitis D if you are already infected with hepatitis B.
Hepatitis D infection can be short-term (less than 6 months) or chronic (you have it your whole life).
Hepatitis D can lead to liver damage and complications including cirrhosis, liver cancer or acute liver failure.
The link between hepatitis B and hepatitis D
Everyone with hepatitis D also has hepatitis B. This is because the hepatitis D virus needs the hepatitis B virus to survive and multiply.
There are 2 types of infection with hepatitis D – co-infection and superinfection.
Co-infection: You catch hepatitis D at the same time you catch hepatitis B. If this happens, you may only have the hepatitis D for a short time (less than 6 months), but you are at a higher risk of developing acute liver failure.
Superinfection: You already have hepatitis B and then you catch hepatitis D. This is the most common form of hepatitis D. People with superinfection often have a long-term, chronic illness (it can last your whole life). You are much more likely to develop cirrhosis and the associated complications, such as liver cancer, if you have chronic hepatitis D.
What are the symptoms of hepatitis D?
You can’t get hepatitis D unless you are infected with hepatitis B. The symptoms are similar in both viruses, but people who also have hepatitis D tend to have more severe symptoms.
The symptoms include:
- fatigue
- loss of appetite
- nausea and vomiting
- abdominal (tummy) pain
- yellow skin and eyes (jaundice)
- dark urine
- pale poo
- muscle and joint pain
- mild fever.
If you develop any of the symptoms above, see your doctor. This is especially important for people who:
- Are already infected with hepatitis B
- Use or inject drugs
- Are a sexual partner of someone infected with Hepatitis B and Hepatitis D
- Are co-infected with HIV and hepatitis B
- Are men who have sex with men
- Are a household contact of someone with hepatitis D
- Are a health care of public safety worker at risk for occupational exposure to blood or blood-contaminated fluids
- Are a haemodialysis patient
Any of these symptoms suggest you may have a severe illness that may be related to viral hepatitis or some other condition that needs diagnosis and treatment.
How is hepatitis D diagnosed?
Hepatitis D is diagnosed through a blood test.
Anyone who knows they have hepatitis B should also be tested for hepatitis D.
Why did I get hepatitis D?
Hepatitis D is spread when infected body fluids (blood, saliva, semen and vaginal fluid) come into contact with the blood stream (for example through broken skin or a needle puncture) or mucous membranes (such as the mouth, throat and genitals).
Anyone with hepatitis B can develop hepatitis D. But it is not very common in Australia. Most people who were born in Australia since May 2000 will have been vaccinated against hepatitis B. This means they can’t get hepatitis D.
Most people with hepatitis D caught it in a country where the virus is more common (Mongolia, Moldova, Sudan or Afghanistan). It may also be caught from sharing injecting equipment such as needles and syringes. Mother to baby transmission at the time of birth is uncommon.
The incubation period (the time between getting infected and developing symptoms) is thought to be between 2 to 8 weeks. All people with hepatitis D are infectious to people who are not vaccinated for hepatitis B.
How is hepatitis D treated?
Until recently there has been no specific treatment for hepatitis D. The medication used to treat hepatitis B doesn’t work very well for hepatitis D.
Some people might be offered treatment with weekly injections of a medication called interferon, although this treatment is not very effective and has a lot of side effects.
A new treatment called bulevirtide was approved for use in Australia in mid-2024. This treatment is not reimbursed through the Pharmaceutical Benefits Scheme and is expensive. It is taken as a daily subcutaneous injection (just below the skin of the tummy or upper thigh) and treatment may be needed for many years. It is effective in reducing the level of virus and the amount of liver inflammation.
Other treatments are under development.
If you have hepatitis D, it’s recommended you keep seeing a liver specialist your whole life.
How can I prevent hepatitis B and hepatitis D?
The best way to avoid getting hepatitis B and D is to be vaccinated against hepatitis B. You need 3 doses of the vaccine over 6 months.
The vaccine is free in Australia for babies at birth and at ages 2 months, 4 months and 6 months.
It is also recommended for:
- All Aboriginal and Torres Strait Islander people
- People whose immune system doesn’t work properly, including before you have a transplant
- People with certain medical conditions
- People whose jobs put them at a higher risk
- People travelling to areas where hepatitis B is more common (such as Asia, Pacific Islands, Africa and Europe)
- People who are at risk of coming into contact with an infected person (for example sexual partners or household contacts).
If you have not been vaccinated, you can avoid catching hepatitis B by:
- Having safe sex (using a condom)
- Not sharing needles or other equipment (eg spoons) when injecting drugs
- Making sure that tattoo or piercing equipment is sterilised
- Covering wounds
- Not sharing razors or toothbrushes
- Using gloves if giving first aid.
These measures will also reduce the risk of catching hepatitis D if you already are living with hepatitis B infection.
Living with hepatitis D
If you have chronic hepatitis D, and of course hepatitis B, it is important that you see your liver specialist regularly.
Even if you are on medication for the hepatitis B, this will not be effective for hepatitis D. That means you can infect someone else.
You should practise safe sex, cover cuts and wounds on your body, never share injecting equipment. Don’t share household items like toothbrushes or razors.
More information
SA Health Sout Australia Health: Hepatitis D
Hepatitis Australia. Hepatitis Delta.
What next?
Call 1800 841 118 to speak to a liver nurse
Read more about living well
References
Reviewed April 2025