What are the causes of hepatitis D? There is only one cause of hepatitis D -- an infection with the hepatitis D virus (also known as HDV or the delta hepatitis agent). The hepatitis D virus is a small RNA virus that belongs to the genus Deltavirus. However, there is one important difference between hepatitis D and other types of viral hepatitis. A person who is infected with the hepatitis D virus must also have a hepatitis B infection in order for the hepatitis D virus to multiply. This is not the case with other types of viral hepatitis.
 
When a person is infected with the hepatitis D virus (and either has active hepatitis B or is co-infected with hepatitis B at the same time), the virus is able to enter liver cells from the blood and then use those cells to make more copies of the hepatitis D virus. As more and more of the hepatitis D virus is made in the liver cells, they can become damaged and may even die.
 
A person infected with the hepatitis D virus may develop a sudden onset of fever, extreme tiredness, nausea, a lack of appetite, abdominal pain (or stomach pain), and yellowing of the skin or whites of the eyes (known as jaundice). Yet, not everyone infected with the hepatitis D virus will develop symptoms. With hepatitis D, a person can also develop a long-term liver infection (known as chronic hepatitis D).

The hepatitis D virus is spread through infected bodily fluids. Infected blood and blood products are among the bodily fluids that can spread hepatitis D. Causes of hepatitis D transmission can include exposure to blood or blood products through working in a laboratory or a dialysis unit, through infected needles used for tattoos or body piercing, or through sharing drug needles. In a very few cases, people have been infected with hepatitis D by sharing objects that may have a very tiny amount of blood on them, such as a toothbrush, razor, or tools used for manicures.
 
Hepatitis D is also spread through contact with other infected bodily fluids, such as semen, vaginal fluids, or saliva. A person cannot get hepatitis D from a kiss or other normal everyday activities, such as hugging or shaking hands.