Hepatitis D

Disease hub

Supporting patients and caregivers with reliable information, research updates, and a community that understands your journey.

HDV

Liver disease

Rare disease

Viral hepatitis

About the condition

What is hepatitis D?

Hepatitis D is a liver infection caused by the hepatitis D virus (HDV). HDV is unusual in that it can only infect people who also have the hepatitis B virus (HBV). This is because HDV relies on HBV to replicate, which is why it is sometimes described as a satellite virus.

Because testing for hepatitis D is not always routine, many people living with hepatitis B may not know they also have hepatitis D. This makes the true scale of the condition difficult to measure and means diagnosis can be significantly delayed.

Co-infection

When a person becomes infected with hepatitis B and hepatitis D at the same time. Co-infection can sometimes clear on its own but can also lead to severe acute hepatitis.

Superinfection

When a person who already has chronic hepatitis B later acquires hepatitis D. Superinfection tends to lead to more serious and persistent liver disease.

Why hepatitis D is serious

Hepatitis D can accelerate liver damage significantly compared to hepatitis B alone. People with both infections have a higher risk of developing cirrhosis and liver failure. Despite this, hepatitis D remains under-recognised and is not always tested for even in people known to have hepatitis B.

Common symptoms

Fatigue

Nausea

Jaundice

Abdominal pain

Joint pain

Some people have no symptoms

Living with hepatitis D

Managing uncertainty in a poorly understood condition

People living with hepatitis D may face significant uncertainty around diagnosis, monitoring, treatment options, and long-term liver health. Because hepatitis D is far less commonly discussed than hepatitis B or C, patients can find it difficult to locate clear and reliable information.

The connection to hepatitis B adds another layer of complexity. People may be managing both infections simultaneously, navigating multiple treatment pathways and monitoring schedules. The psychological impact of living with a serious liver condition that is not well known, even among some healthcare professionals, can be considerable.

Fatigue is common and can affect work, relationships, and daily life. The uncertainty about how the condition may progress over time, and what options may be available in future, can be one of the harder aspects to live with, for patients and caregivers alike.

Hepatitis D is estimated to affect around 5% of people with chronic hepatitis B worldwide, yet it remains one of the most under-diagnosed forms of viral hepatitis.

Research

Where is research heading?

Research in hepatitis D is active and evolving. Current focus areas include:

New treatments

Several new antiviral therapies targeting HDV are in development or have recently received approval, representing a significant step forward for patients with limited options.