Hepatitis D

Symptoms and diagnosis

The symptoms of hepatitis D are similar to hepatitis B monoinfection. In a recent (acute) infection, there are often no symptoms. It can cause mild flu-like symptoms, pale stools, dark urine, fever or yellowing of the skin and/or eyes.

In chronic infection, most people have no symptoms until they develop cirrhosis or liver cancer. The most common symptom of chronic hepatitis B and D is fatigue.

A hepatitis D diagnosis can only be made if there are also hepatitis B surface antigen (HBsAg) present. HBsAg is the outer surface, or ‘envelope’, of the hepatitis B virus. The delta virus needs this to reproduce.



Something the immune system can recognise as 'foreign' and attack.


Scarring of the liver – the structure of the liver is altered. See also ‘fibrosis’, which is moderate scarring. See also ‘compensated cirrhosis’ and ‘decompensated cirrhosis’.


Having one infection. Often used in contrast to coinfection, for example when people have both hepatitis B and HIV.


Polymerase chain reaction, a method of amplifying fragments of genetic material so that they can be detected. Some viral load tests use this method.

If hepatitis D is suspected, then a test for antibodies would be performed. If the test is positive, then a PCR test for hepatitis D antigen is required to distinguish between an infection that is currently active and one that has been cleared. This test is only available in a few specialised laboratories.

This information is provided by Deutsche Leberhilfe e.V.