Viral hepatitis D (delta-hepatitis) is an infectious liver disease, co-infection or superinfection of viral hepatitis B, which significantly worsens its course and prognosis. Viral hepatitis D belongs to the group of transfusion hepatitis, the mandatory condition for infection with hepatitis D is the presence of an active form of hepatitis B. The detection of the hepatitis D virus is carried out by PCR. A liver examination is mandatory: biochemical tests, ultrasound, MRI, and rheopathography. Treatment of viral hepatitis D is similar to that of hepatitis B, but it requires a high dosage of drugs and a longer period of their intake. In most cases, the disease is chronic with subsequent outcome in cirrhosis of the liver.
- Characteristics of the pathogen
- Symptoms of viral hepatitis D
- Diagnosis of viral hepatitis D
- Treatment of viral hepatitis D
- Prognosis and prophylaxis of viral hepatitis D
- Treatment prices
- Viral hepatitis D
- Viral hepatitis D (delta-hepatitis) is an infectious liver disease, co-infection or superinfection of viral hepatitis
- B, which significantly worsens its course and prognosis. Viral hepatitis D belongs to the group of transfusion hepatitis.
Characteristics of the pathogen
Hepatitis D is caused by an RNA-containing virus, which is the only known representative of the “wandering” genus Deltavirus, which is characterized by the inability to self-form the protein for replication and uses for this protein produced by the hepatitis B virus. Thus, the causative agent of hepatitis D is a satelitis virus and occurs only in combination with the hepatitis B virus.
The hepatitis D virus is extremely stable in the external environment. Heating, freezing and thawing, exposure to acids, nuclease and glycosidases do not significantly affect its activity. The reservoir and the source of infection are patients with a combined form of hepatitis B and D. Contagiosity is particularly pronounced in the acute phase of the disease, but patients present an epidemic danger throughout the whole circulatory period of the virus in the blood.
The mechanism of transmission of viral hepatitis D is parenteral, an essential condition for the transmission of the virus is the presence of active hepatitis B virus. The hepatitis D virus is integrated into its genome and enhances the replication ability. The disease can be a co-infection when the hepatitis D virus is transmitted simultaneously with B, or superinfection, when the pathogen enters the body already infected with the hepatitis B virus. The most significant risk of infection when blood is transfused from infected donors is notable epidemiological significance are surgical interventions, traumatic medical manipulation (for example, in dentistry).
Hepatitis D virus is able to overcome the placental barrier, can be transmitted sexually (the spread of this infection among people prone to promiscuous sexual relations, homosexuals), which in some cases has a family spread of the virus suggests the possibility of its transmission through a contact-household way. Patients with viral hepatitis B, as well as carriers of the virus, are susceptible to viral hepatitis D. In particular, the susceptibility of individuals in whom the chronic carrier of HBsAg is detected is high.
Symptoms of viral hepatitis D
Viral hepatitis D supplements and heaves the course of hepatitis B. The incubation period of co-infection is significantly reduced, is 4-5 days. Incubation of superinfection lasts 3-7 weeks. The pre-hepatic period of hepatitis B proceeds similarly to that of hepatitis B, but has a shorter duration and more turbulent flow. Superinfection can be characterized by early development of edematous-ascitic syndrome. The icteric period proceeds as well as with hepatitis B, but bilirubinemia is more pronounced, more often signs of hemorrhage are manifested. Intoxication in the icteric period of hepatitis D is significant, prone to progression.
Coinfection takes place in two phases, the interval between peaks of clinical symptoms is 15-32 days. Superinfection is often difficult to diagnose differential diagnosis, since its course is similar to that of hepatitis B. The characteristic difference is the speed of the clinical picture deployment, fast process chronicization, hepatosplenomegaly, the breakdown of protein synthesis in the liver. Recovery takes a much longer time than in the case of hepatitis B, residual asthenia can persist for several months.
Chronic viral hepatitis D does not differ in specific symptoms, it is similar to chronic hepatitis of another etiology. Patients are disturbed by general weakness and fatigue, from time to time there may be “causeless” episodes of fever with a fever without catarrhal symptoms, accompanied by a sub jaundice and jaundice. On the skin formed secondary hepatic signs (palmar erythema, vascular sprockets), the liver and spleen are enlarged, often develop hepatic edema, ascites.