NAME: Hepatitis D
SYNONYM OR CROSS REFERENCE: Viral hepatitis D, delta hepatitis, delta agent hepatitis, delta-associated hepatitis, HDV
CHARACTERISTICS: Defective 35- 43 nm diameter virus consisting of a coat of HBsAg and a unique internal antigen (delta antigen); within the delta antigen is a single-stranded RNA in either circular or linear conformation; HDV requires co-infection with HBV for HDV viral replication
PATHOGENICITY: Two major types of HDV infections noted: simultaneous HDV and HBV infections or HDV superinfection in chronic HBV patients; simultaneous HDV and HBV infections are clinically indistinguishable from acute hepatitis A or B; fulminant hepatitis is more common than with HBV alone; HDV superinfection in HBV individuals suffer relapse of jaundice and most develop chronic cirrhosis, epidemics have occurred and resulted in rapidly progressive liver disease, with 20% mortality
EPIDEMIOLOGY: Worldwide: highest prevalence in Italy, Middle East, Africa and South America; in Mediterranean countries, infections are endemic in persons with HBV, and are mostly transmitted by intimate contact; non-endemic areas, infections are confined to individuals that are exposed to blood and blood products, mostly drug addicts and hemophiliacs
HOST RANGE: Humans; experimental infection in chimpanzees and woodchuck
INFECTIOUS DOSE: Not known
MODE OF TRANSMISSION: Percutaneous spread, needles, injecting: exposure to blood and serous body fluids, contaminated needles, syringes and plasma derivatives; sexual transmission: person-to-person contact
INCUBATION PERIOD: Varies from 2 to 12 weeks or months depending on size of inoculums; shorter in HBV carrier individuals
COMMUNICABILITY: Blood is potentially infectious during all phases of the active HDV infection; peak infectivity mostly prior to the onset of acute illness
RESERVOIR: Humans; infection experimentally transmitted to HBV infected chimpanzees and woodchucks
ZOONOSIS: Not known
VECTORS: None
DRUG SUSCEPTIBILITY: No specific antiviral available to date
SUSCEPTIBILITY TO DISINFECTANTS: Sensitive to 1% sodium hypochlorite, 2% glutaraldehyde
PHYSICAL INACTIVATION: Sensitive to heat
SURVIVAL OUTSIDE HOST: Survives for long periods in blood or blood products
SURVEILLANCE: Monitor for symptoms; confirm by serological analysis or nucleic hybridization for presence of viral RNA, RIA or EIA, reverse transcriptase PCR
FIRST AID/TREATMENT: No specific treatment
IMMUNIZATION: HBV vaccine protects against HBV infection and presumable coinfection with HBV-HDV; however, neither HBV vaccine nor HBIG will prevent HDV infection among persons with chronic HBV
PROPHYLAXIS: None available
LABORATORY-ACQUIRED INFECTIONS: None reported to date
SOURCES/SPECIMENS: Blood and blood products, urine, semen, CSF
PRIMARY HAZARDS: Accidental parenteral inoculation; droplet exposure of mucous membrane; contact exposure of broken skin
SPECIAL HAZARDS: Sharps containing infected blood
CONTAINMENT REQUIREMENTS: Biosafety level 2 practices and containment facilities for all activities involving viruses, contaminated or potentially contaminated body fluids or tissues
PROTECTIVE CLOTHING: Laboratory coat and gloves
OTHER PRECAUTIONS: None
SPILLS: Allow aerosols to settle; wearing protective clothing, gently cover spill with absorbent paper towel and apply 1% sodium hypochlorite, starting at the perimeter and working towards the centre; allow sufficient contact time (30 mins) before clean up
DISPOSAL: Decontaminate before disposal; steam sterilization, chemical disinfection, incineration
STORAGE: In sealed containers that are appropriately labelled
Date prepared: May, 2001
Prepared by: Office of Laboratory Security, PHAC
Although the information, opinions and recommendations contained in this Material Safety Data Sheet are compiled from sources believed to be reliable, we accept no responsibility for the accuracy, sufficiency, or reliability or for any loss or injury resulting from the use of the information. Newly discovered hazards are frequent and this information may not be completely up to date.
Copyright ©
Health Canada, 2001