755 Bloodborne Pathogens Program Management

Hepatitis D Virus (HDV)

HDV is known as a "satellite virus," because it can only infect people who are also infected by the hepatitis B virus (HBV). HDV infection can be acute or lead to chronic, long-term illness. The infection can be acquired either simultaneously with HBV as a coinfection or as a superinfection in people who are already chronically infected with HBV.

HDV infection is uncommon in the United States, where most cases occur among people who migrate or travel to the United States from countries with high HDV infection rates. Because hepatitis D is not a nationally notifiable condition, the actual number of hepatitis D cases in the United States is unknown.

HDV is mainly transmitted through activities that involve percutaneous (i.e., puncture through the skin) and to a lesser extent through mucosal contact with infectious blood or body fluids (e.g., semen and saliva).

HDV causes infection and clinical illness only in HBV-infected people. The signs and symptoms of acute HDV infection are indistinguishable from those of other types of acute viral hepatitis infections.

Hepatitis E Virus (HEV)

HEV is found in the stool of an infected person. It is spread when someone unknowingly ingests the virus – even in microscopic amounts.

In developing countries, people most often get hepatitis E from drinking water contaminated by feces from people who are infected with the virus. In the United States and other developed countries where hepatitis E is not common, people have gotten sick with hepatitis E after eating raw or undercooked pork, venison, wild boar meat, or shellfish.

Symptoms of hepatitis E can include fatigue, poor appetite, stomach pain, nausea, and jaundice. However, many people with hepatitis E, especially young children, have no symptoms. Except for the rare occurrence of chronic hepatitis E in people with compromised immune systems, most people recover fully from the disease without any complications. No vaccine for hepatitis E is currently available in the United States.

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