For health professionals: Hepatitis D

Get detailed information on hepatitis D for health professionals.

On this page

• What health professionals need to know about hepatitis D
• Diagnosis
• Treatment
• For more information

What health professionals need to know about hepatitis D

Hepatitis D is a liver disease caused by the hepatitis D virus.

There are 2 major types of infection:

• hepatitis D and B co-infection (results in clinical hepatitis which is indistinguishable from acute hepatitis B)
• hepatitis D superinfection (in individuals with chronic hepatitis B)

The disease is self-limiting, and complete viral clearance occurs in more than 90% of cases with co-infection.

Hepatitis D superinfection generally causes severe acute hepatitis and leads to chronic hepatitis D infection. Individuals with chronic hepatitis D can develop cirrhosis or fulminant hepatitis. Fulminant hepatitis is characterized by severe hepatitis and encephalopathy and has a mortality rate of almost 80%. 

Diagnosis

Monitor for symptoms. Diagnosis is based on serological testing for the presence of IgM or IgG antibodies to the delta antigen. Polymerase chain reaction (PCR) can also be used to detect viral RNA (or viral genome) in clinical samples.

Treatment

Hepatitis D is challenging to treat because of the severity of resulting illness and the distinctiveness of this virus. Long-term treatment with high doses of pegylated IFN-α shows improvement in 20% of cases. In August 2025, Health Canada approved bulevirtide, an entry inhibitor, as the first targeted therapy for chronic HDV infection in adults with compensated liver disease.