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Iowa Department of Health and Human Services

Hepatitis D


Hepatitis D is a virus that infects the liver. Hepatitis D, or Delta hepatitis, is always associated with a hepatitis B infection. A person may recover from Delta hepatitis or it may progress to chronic hepatitis.

Hepatitis D is reportable to the Iowa Department of Public Health by Iowa Administrative Code 641 Chapter 1.


Onset of hepatitis D is usually sudden. Symptoms include:

  • Tiredness
  • Nausea
  • Vomiting
  • Fever
  • Stomach pain
  • Tea-colored urine
  • Yellowing of the skin and eyes (jaundice).

Hepatitis D infection in someone with chronic hepatitis B may be misdiagnosed as a worsening of chronic hepatitis B.


The hepatitis D virus is spread by exposure to blood and serous body fluids, contaminated needles and syringes, and via sexual transmission.

Risk Factors

Hepatitis D can only occur if the person has hepatitis B. Hepatitis D virus (HDV) and hepatitis B virus (HBV) may infect a person at the same time or HDV infection may occur in persons with chronic HBV infection. Others risk groups include:

  • Injection drug users
  • Persons with hemophilia
  • Infants/children of immigrants from areas with high rates of HBV infection
  • Household contacts of chronically infected persons
  • Persons with multiple sex partners or diagnosis of a sexually transmitted disease
  • Men who have sex with men
  • Sexual contacts of infected persons
  • Infants born to infected mothers
  • Health care and public safety workers
  • Hemodialysis patients


  • There is no vaccine for hepatitis D. Hepatitis B vaccine is the best protection. Protection is given because only people infected with hepatitis B virus can become infected with hepatitis D virus.
  • Latex condoms are recommended for sexually active individuals, especially those having sex with more than one partner. The efficacy of latex condoms in preventing infection with HBV is unknown, but their proper use may reduce transmission.
  • Pregnant women should get a blood test for hepatitis B infection (HBV). Infants born to HBV-infected mothers should be given HBIG (hepatitis B immune globulin) and vaccine within 12 hours after birth.
  • Injection drug users should be encouraged to discontinue injection drug use and to enroll in a treatment program; to never share needles, syringes, water, or "works;" and to get vaccinated against hepatitis A virus (HAV) and HBV.
  • Individuals should not share personal care items that might be contaminated with blood (i.e. razors, toothbrushes).
  • Patients should be encouraged to consider the risks of tattoos or body piercings.
  • Patients who have had HBV should not donate blood, organs, or tissue.
  • Health care or public safety workers should get vaccinated against HBV, always follow routine barrier precautions, and safely handle needles and other sharps


There is no specific treatment that can make the infection go away. People who are sick with hepatitis D should see a doctor for advice about how to control their symptoms.

Additional Resources