Take care of your liver

Hepatitis Delta

Questions and answers
for awareness and management

What is HDV?

Hepatitis Delta (or hepatitis D) is a chronic inflammation of the liver caused by infection with two viruses, the hepatitis B virus (HBV) and the hepatitis D virus (HDV): ^1,4 HDV cannot cause infection by itself; it requires the presence of HBV to multiply in liver cells.^{4, 5}

Anyone with hepatitis B is at risk of hepatitis D.⁴

Risk factors

Hepatitis Delta is transmitted through contact with blood and other body fluids of an infected person.⁶ For example, through^4,7:

punctures and cuts with infected objects
sharing personal items (e.g. razors and toothbrushes)
sharing needles and syringes with infected people
unprotected sex
piercings and tattoos performed with non-sterile instruments
birth by an infected mother

Symptoms

The infection often causes no obvious symptoms. These include⁴:

muscle and joint pain
fever
malaise
tiredness
loss of appetite
abdominal pain
itching
dark urine and pale stools
aundice

Possible complications

Hepatitis Delta has more serious clinical consequences than hepatitis B² and is characterised by a more rapid progression than hepatitis B^2,3: the risk of cirrhosis and cancer is greater, thus increasing the likelihood of requiring a liver transplant or death, even at a young age.¹

The International Agency for Research on Cancer (IARC) has classified HDV, the virus that causes hepatitis Delta, as a human carcinogen, just like HBV or HCV. This is why the World Health Organization (WHO) has called on governments to urgently accelerate efforts to eliminate this public health threat and reduce liver cancer deaths. Hepatitis D, which only affects individuals infected with hepatitis B, is in fact associated with a risk of liver cancer two to six times greater than hepatitis B alone.³

Helpful tips

It is essential that all patients with hepatitis B and most at-risk subjects undergo frequent testing for HDV, in order to diagnose the disease as soon as possible and avoid severe liver damage.⁸
If you have been diagnosed with HDV, trust your Doctor who will give you all the instructions you need to follow the treatments correctly.
In addition to therapies, it is very important to have a healthy lifestyle to promote the correct functioning of the liver: avoid alcohol, practice daily physical activity, pursue your interests, follow a healthy diet, set time aside for meditation, and maintain a positive attitude.^8,9
Always follow your Doctor’s instructions, do not skip the prescribed doses and do not interrupt the therapies of your own initiative.

To learn more click here

Download the brochure

Discover the “Test in the city” initiative

to take free tests for HBV, HCV, and HIV and receive information and assistance on hepatitis Delta.

Find out more

To take the test and receive further information, always refer to your Local Health Authority.

Bibliographic references

1. Quaranta MG et al. Not Ist Super Sanità 2024;37(1):11-16.
2. Miao Z et al.J Infect Dis 2020;221(10):1677-87
3. WHO website. WHO urges action on hepatitis, announcing hepatitis D as carcinogenic. Available on: https://www.who.int/news/item/28-07-2025-who-urges-action-on-hepatitis-announcing-hepatitisd-as-carcinogenic. Last access: November 2025.
4. ISS, Istituto Superiore di Sanità (Italian National Institute of Health). Hepatitis D: disorders, causes and treatment. https://www.issalute.it/index.php/la-salute-dalla-a-alla-z-menu/e/epatited#:~:text=L%E2%80%99epatite%20virale%20da%20virus%20D%20(e%20da%20virus%20B)%20 si. Last access: October 2024.
5. ISS, Italian National Institute of Health. Hepatitis Delta (D) https://www.epicentro.iss.it/epatite/epatite-d#:~:text=L%E2%80%99infezione%20da%20virus%20D%20%C3%A8%20diffusa%20in%20tutto,in%20grado%20di%20proteggere%20anche%20contro%20l%E2%80%99-epatite%20D. Last access: October 2024.
6. Da BL et al. Gastroenterol Rep 2019;7(4):231-45
7. CDC, Center for Disease Control and Prevention. Hepatitis D Basics. https://www.cdc.gov/hepatitis-d/about/index.html#:~:text=Hepatitis%20D%20is%20a%20liver%20disease%20caused%20by%20the%20hepatitis. Last access: October 2024.
8. Zovich B et al. J Viral Hepat 2024. doi: 10.1111/jvh.14005.
9. Kumar P et al. Prev Chronic Dis 2020;17:E159

Material Code: IT-UNB-3142

Hepatitis Delta

Questions and answers for awareness and management