How easy it is to become super-infected with Hepatitis D

Hello,

I am a Hepatitis B carrier. For several years, I have been classified by my hepatologist as a "healthy carrier": Low HBV DNA and nornal liver enzymes. With regular monitoring, chances are very good that I won't encounter any trouble related to Hepatitis B in my lifetime.

I read that super-infection with Hepatitis D can drastically reverse the good prognosis. A Hepatitis B carrier who becomes chronically infected with Hepatitis D can expect to suffer from cirrohsis within a couple years! Treatments for the superinfection aren't robust yet. Worse, there is no effective vaccine to prevent Hepatitis D among Hepatitis B carriers. Non-carriers can rely on the Hep B vaccine for protection against Hep D, but the Hep B vaccine does not do anything for carriers.

So how easy it is to become exposed to the Hepatitis D virus? It appears that Hepatitis D is a top threat to Hepatitis B carriers.

[PinoyHBVDNA]

hepatitis D is quite rare and an estimated 15M people are infected worldwide

15000000/ 7000000000 = 0.21% of the world population
15000000/ 350000000 = 4.2% of the HEPB population

same route of infection as HBV, just be careful.

[begals]

4.2% is quite common!

I think I may be accurate in saying that it is quite dangerous for two HBV carriers to have casual sex. I mean, HIV dies quickly once exposed to air.  HCV rarely spread by sexual intercourse. HDV, on the other hand, may spread just as easily as HBV. Since HBV is a hardy virus that can survive in dried fluid for a long time, don't you think condom isn't safe enough? Just think of the HBV virus transfering from the dried fluid to the hand, and then land on the eyes, nose, or other mucous membranes.

[PinoyHBVDNA]

but majority of the 4.2% is localed in the mediterrenean :)

Being careful is the only way CHB people will be able to avoid HDV because HDV test is rare, honestly i dont even know a single medical institution here in the Philippines that has HDV testing.

And how will you know that your partner also has HBV, let alone HDV?

[stef2011]

hdv is quite common in some areas, mediterranean area is for example.....

it is super infective and you can get it in healthcare setting more than other ways....densits is also a good way to get it, there is no way to avoid it unless you are the first person in the studio and nobody before you.of course everything must be perfectly disinfected

everything is not available in the philippines.....all other countries have it, it doesn t matter if rich or poor.the test is stupid and cheap, anti-hdv igm and igg

[4est]

a HDV super infection on a chronic HBV is mandatory to chronic or it is possible to go acute and if you know the % .

[4est]

looks like 80% go chronic - http://www.who.int/csr/disease/hepatitis/whocdscsrncs20011/en/index3.html

[4est]

do you know something regarding HDV vaccine ?
I heard some rummer reading that a vaccine in animal model was presented to easl.

[PinoyHBVDNA]

for CHB people there is no HDV vaccine, but for non CHB people all they need is HBV vaccine because HDV needs HBV to exist

[begals]

Just came across this article that summaries HDV:

http://www.pkids.org/files/pdf/phr/04-00hdv.pdf

What I understand from the article is that HDV super-infection is more or less a death sentence. Prevention is still the only hope today.

[PinoyHBVDNA]

i read the PDF file and it's scary...

[jonny168]

i've read about this too ... i hope myrcludex b for HBV & HDV comes out soon for people suffering this superinfections

[stef2011]

therapy for hdv is interferon long time+tenofovir or + truvada

[jonny168]

oh ... ok. that was only the thing that popped in my mind from prior readings.

[4est]

"for CHB people there is no HDV vaccine, but for non CHB people all they need is HBV vaccine because HDV needs HBV to exist" - I'm sure that I read somewhere that they test a HDV vaccine in animals and the results was a good one (regarding the people that don't have HBV, you are correct, HVB vaccine will protect also for HDV).

[begals]

The trouble with interferon is that it causes permanent harms to the body with long-term use. Brain damage can result from constant stimulation of immune cells inside the brain. The patient must get off interferon eventually. So it is not a sustainable treatment.

[stef2011]

hbv+hdv will kill you so......the sides are only on older people and a low percentage

if liver damage is not too bad it is better to wait for interferon lambda which has very mild sides

[4est]

some time the hdv is get cleard with a combo, see http://www.medhelp.org/posts/Hepatitis-B/entecavir--pegasys-for-hepatitis-BD/show/1487355#post_6759673

@stef2011 - elena was advice for entecavir + pegasyus by a italian doctor, so as you say combo look very good for the future.