Hepatitis D is inflammation of the liver caused by the hepatitis D virus (HDV), a defective RNA virus that requires the hepatitis B surface antigen (HBsAg) provided by hepatitis B virus (HBV) for viral entry, assembly, and secretion; HDV infection therefore cannot occur in the absence of HBV co-infection or superinfection [1][2].
Disease overview
Hepatitis D
丁型肝炎
Evidence-backed informationEN 5/7 applicable sections · ZH 5/7 applicable sectionsUpdated Sep 3, 2026
Hepatitis D is a liver inflammation caused by the hepatitis D virus (HDV), which depends on hepatitis B virus (HBV) for replication and cannot occur without it [1]. Co-infection with HDV and HBV is regarded as the most severe form of chronic viral hepatitis because of its accelerated progression toward cirrhosis and hepatocellular carcinoma [1][2]. HDV has been recently reclassified by the IARC Monographs Programme as carcinogenic to humans (class I) [1]. Globally, an estimated 12 million people have experienced HDV infection, and HDV accounts for roughly one in five cases of cirrhosis or liver cancer among HBsAg-positive individuals [3].
Read the full clinical and epidemiological profile6
Acute HDV–HBV co-infection is cleared of both viruses in approximately 95% of affected individuals, whereas HDV superinfection of an existing HBV carrier leads to chronic HDV-HBV infection in more than 90% of cases [2]. Chronic hepatitis D produces more rapidly progressive liver disease than HBV monoinfection, with roughly 30–70% of patients having cirrhosis at diagnosis and more than 50% dying of liver disease within 10 years, although recent data suggest a more indolent course in over half of those infected [2]. Only about 20–50% of infected people have been diagnosed, reflecting limited awareness and restricted access to reliable HDV antibody and RNA testing [2].
The global anti-HDV prevalence among HBsAg-positive people is estimated at 4.5% (95% CI 3.6–5.7), corresponding to approximately 12 million (range 8.7–18.7 million) anti-HDV-positive individuals, or 0.16% of the general population [3]. Among hepatology-clinic attendees who are HBsAg-positive, prevalence rises to about 16.4% (95% CI 14.6–18.6) [3]. Identified hotspots include Mongolia, the Republic of Moldova, and countries in Western, Middle, and Central Africa, and higher prevalence is observed among people who inject drugs, haemodialysis recipients, men who have sex with men, commercial sex workers, and those co-infected with HCV or HIV [1][3]. The population-attributable fraction of HDV for cirrhosis and hepatocellular carcinoma among HBsAg-positive people is estimated at 18% and 20%, respectively [3].
HDV is blood-borne and shares the transmission routes of HBV, occurring through contact with infected blood or other body fluids, sexual intercourse, and—rarely—vertical transmission from mother to child before or around birth [1]. Within households in endemic areas, intrafamilial spread has also been documented [1].
Standard blood-borne-pathogen precautions—safe injection practices, screening of blood products, harm-reduction measures for people who inject drugs, and barrier protection during sexual contact—further reduce HDV transmission [1].
- 1World Health Organization. Hepatitis D [Internet]. cited 3 Sept 2026.Available from: https://www.who.int/news-room/fact-sheets/detail/hepatitis-d
- 2Negro F et al. Hepatitis D: A Review. JAMA. 2023 Dec 26. PMID: 37943548. doi: 10.1001/jama.2023.23242.PubMed: https://pubmed.ncbi.nlm.nih.gov/37943548/
- 3Stockdale AJ et al. The global prevalence of hepatitis D virus infection: Systematic review and meta-analysis. J Hepatol. 2020 Sep. PMID: 32335166. doi: 10.1016/j.jhep.2020.04.008.PubMed: https://pubmed.ncbi.nlm.nih.gov/32335166/
- B17.0
- 1E50.3
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Australia NINDSS
Australia
Australian national notifiable diseases surveillance dashboard.
Australia NINDSS — Australian Capital Territory
Australian Capital Territory, Australia
Australian NINDSS monthly state/territory notifications for Australian Capital Territory, kept separate from the Australia national aggregate.
Australia NINDSS — New South Wales
New South Wales, Australia
Australian NINDSS monthly state/territory notifications for New South Wales, kept separate from the Australia national aggregate.
Australia NINDSS — Northern Territory
Northern Territory, Australia
Australian NINDSS monthly state/territory notifications for Northern Territory, kept separate from the Australia national aggregate.
Australia NINDSS — South Australia
South Australia, Australia
Australian NINDSS monthly state/territory notifications for South Australia, kept separate from the Australia national aggregate.
Australia NINDSS — Tasmania
Tasmania, Australia
Australian NINDSS monthly state/territory notifications for Tasmania, kept separate from the Australia national aggregate.
Australia NINDSS — Western Australia
Western Australia, Australia
Australian NINDSS monthly state/territory notifications for Western Australia, kept separate from the Australia national aggregate.
China CDC Weekly
China
Monthly notifiable infectious disease reports published by China CDC.
National Disease Control and Prevention Administration
China
Official China public health bulletin and query portal.
PubMed
China
Biomedical literature discovery feed used as supplementary context.
Public Health Science Data Center
Anhui, China
Chinese province-level historical monthly observations; this higher-priority source overlays overlapping official monthly reports.
Provincial statutory infectious disease monthly report
Anhui, China
Province-level statutory infectious disease report published by the responsible health authority.
Public Health Science Data Center
Chongqing, China
Chinese province-level historical monthly observations; this higher-priority source overlays overlapping official monthly reports.
Provincial statutory infectious disease monthly report
Chongqing, China
Province-level statutory infectious disease report published by the responsible health authority.
Public Health Science Data Center
Guangdong, China
Chinese province-level historical monthly observations; this higher-priority source overlays overlapping official monthly reports.
Provincial statutory infectious disease monthly report
Guangdong, China
Province-level statutory infectious disease report published by the responsible health authority.
Public Health Science Data Center
Gansu, China
Chinese province-level historical monthly observations; this higher-priority source overlays overlapping official monthly reports.
Provincial statutory infectious disease monthly report
Gansu, China
Province-level statutory infectious disease report published by the responsible health authority.
Public Health Science Data Center
Henan, China
Chinese province-level historical monthly observations; this higher-priority source overlays overlapping official monthly reports.
Provincial statutory infectious disease monthly report
Henan, China
Province-level statutory infectious disease report published by the responsible health authority.
Public Health Science Data Center
Sichuan, China
Chinese province-level historical monthly observations; this higher-priority source overlays overlapping official monthly reports.
Provincial statutory infectious disease monthly report
Sichuan, China
Province-level statutory infectious disease report published by the responsible health authority.
Public Health Science Data Center
Shandong, China
Chinese province-level historical monthly observations; this higher-priority source overlays overlapping official monthly reports.
Provincial statutory infectious disease monthly report
Shandong, China
Province-level statutory infectious disease report published by the responsible health authority.
Public Health Science Data Center
Shanghai, China
Chinese province-level historical monthly observations; this higher-priority source overlays overlapping official monthly reports.
Provincial statutory infectious disease monthly report
Shanghai, China
Province-level statutory infectious disease report published by the responsible health authority.
Public Health Science Data Center
Xinjiang, China
Chinese province-level historical monthly observations; this higher-priority source overlays overlapping official monthly reports.
Provincial statutory infectious disease monthly report
Xinjiang, China
Province-level statutory infectious disease report published by the responsible health authority.
Public Health Science Data Center
Zhejiang, China
Chinese province-level historical monthly observations; this higher-priority source overlays overlapping official monthly reports.
Provincial statutory infectious disease monthly report
Zhejiang, China
Province-level statutory infectious disease report published by the responsible health authority.
Finland THL Infectious Diseases Register
Finland
Finland THL Infectious Diseases Register national monthly case counts. The current month is ingested as provisional and the latest three months are refreshed for source revisions.
Hong Kong, China CHP Notifiable Diseases
Hong Kong, China
Hong Kong, China CHP annual notifiable infectious disease CSVs normalized to national monthly totals
Sweden Public Health Agency SmiNet
Sweden
Sweden SmiNet national monthly reported cases from the official Public Health Agency statistics pages; public release is enabled with closed-month publication and revisable recent-month refreshes.
Taiwan, China CDC NIDSS
Taiwan, China
Taiwan, China monthly notifiable infectious disease open-data CSV feed.