Molecular epidemiology and clinical characteristics of hepatitis D virus infection in Canada

Osiowy, Carla; Swidinsky, Ken; Haylock‐Jacobs, Sarah; Sadler, Matthew D; Fung, Scott; Wong, David; Minuk, Gerald Y.; Doucette, Karen; Wong, Philip; Tam, Edward; Cooper, Curtis; Ramji, Alnoor; Ma, Mang; Nudo, Carmine; Tsoi, Kim; Coffin, Carla S.

doi:10.1016/j.jhepr.2022.100461

Cited by 12 publications

(15 citation statements)

References 44 publications

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“…[2] Patients with HBV/HDV have a higher risk of developing progressive fibrosis, cirrhosis, and hepatocellular carcinoma (HCC) compared with patients with HBV monoinfection. [6][7][8][9][10] HDV is an important contributor to the burden of liver disease; it is estimated to be responsible for 18% of cirrhosis and 20% of HCC among those with HBV infection. [11] This review provides an overview of the epidemiology of and screening for HDV infection, viral replication and natural history of infection, and diagnostic and therapeutic options available now and in development.…”

Section: Introductionmentioning

confidence: 99%

Hepatitis Delta Infection: A Clinical Review

Pearlman

2023

Semin Liver Dis

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First discovered over 40 years ago, the hepatitis delta virus (HDV) is a unique RNA virus, requiring hepatitis B virus (HBV) antigens for its assembly, replication, and transmission. HBV and HDV can be acquired at the same time (coinfection) or HDV infection can occur in persons with chronic HBV (superinfection). Screening guidelines for HDV are inconsistent. While some guidelines recommend universal screening for all people with HBV, others recommend risk-based screening. Estimates of the global HDV prevalence range from 4.5% to 14.6% among persons with HBV; thus, there may be up to 72 million individuals with HDV worldwide. HDV is the most severe form of viral hepatitis. Compared to HBV monoinfection, HDV coinfection increases the risk of cirrhosis, hepatocellular carcinoma, hepatic decompensation, mortality, and necessity for liver transplant. Despite the severity of HDV, there are few treatment options. Pegylated interferon (off-label use) has long been the only available treatment, although bulevirtide is conditionally approved in some European countries. There are many potential treatments in development, but as yet, there are few effective and safe therapies for HDV infection. In conclusion, given the severity of HDV disease and the paucity of treatments, there is a great unmet need for HDV therapies.

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Section: Introductionmentioning

confidence: 99%

Hepatitis Delta Infection: A Clinical Review

Pearlman

2023

Semin Liver Dis

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“…The significant association between HDV viraemia and increased ALT levels has also been described in both univariate and multivariate analyses in a cross-sectional study of over 1.500 patients from 15 countries. 31 Also, in a recent retrospective analysis on prevalence and clinical characteristics of HDV in Canada, Osiowy et al 32 showed that patients infected with HDV were also more likely to suffer severe liver disease and its complications, compared to HDV non-viremic subjects.…”

Section: Discussionmentioning

confidence: 99%

Anti‐HDV reflex testing in HBsAg‐positive subjects: An efficacious strategy to identify HDV infection

Cossiga,

Brusa,

Montalti

et al. 2023

Liver International

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Background and AimsThe prevalence of HDV infection in HBsAg carriers is about 9.9% in Italy. However, the real prevalence is underestimated because the anti‐HDV test is not performed routinely in all HBsAg carriers. The aim of this study was to compare the prevalence and the absolute number of HDV infection identified in HBsAg‐positive subjects tested at University Hospital Federico II before and after the introduction of anti‐HDV reflex testing.MethodsFrom January to December 2022, reflex test for the detection of total HDV antibodies was performed in all HBsAg‐positive subjects tested at University Hospital Federico II. The control group consisted of all the HBsAg‐positive subjects tested at the same laboratory in 2019, before the implementation of anti‐HDV reflex testing. Sera were evaluated with ADVIA Centaur HBsAgII Qualitative, Liaison Murex HBsAg Quantitative and Liaison Murex Total Anti‐HDV Qualitative.ResultsBefore reflex testing, anti‐HDV had been tested in 16.4% (84/512) of HBsAg‐positive subjects, while after its implementation, 100% (484/484) of HBsAg‐positive patients was tested for anti‐HDV. The anti‐HDV positive prevalence was lower than before the introduction of reflex test (10.7% vs. 16.6%) but the absolute number of anti‐HDV positive patients increased (14 vs. 52 subjects). HDV‐RNA was detectable in 26 (53%) of 49 tested subjects.ConclusionsOur data showed that the implementation of anti‐HDV reflex testing increased the diagnoses of HDV infection. In this setting, due to the approval of specific anti‐HDV drugs, a reflex test for anti‐HDV should be implemented to early identify patients with HBV/HDV infection.

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“…All ten individuals with detectable HDV RNA in our study were infected with HDV genotype 1. HDV genotype 1 is the most common HDV genotype overall and in North America and Europe 9,42 . Genotypes 2 and 4 are predominantly seen in Asia, genotype 3 in South America, and genotypes 5–8 in Africa 1 .…”

Section: Discussionmentioning

confidence: 99%

Prevalence and determinants of hepatitis delta virus infection among HIV/hepatitis B‐coinfected adults in care in the United States

Ferrante,

Kallan,

Sukkestad

et al. 2023

Journal of Viral Hepatitis

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Hepatitis delta virus (HDV) infection increases the risk of liver complications compared to hepatitis B virus (HBV) alone, particularly among persons with human immunodeficiency virus (HIV). However, no studies have evaluated the prevalence or determinants of HDV infection among people with HIV/HBV in the US. We performed a cross‐sectional study among adults with HIV/HBV coinfection receiving care at eight sites within the Center for AIDS Research Network of Integrated Clinical Systems (CNICS) between 1996 and 2019. Among patients with available serum/plasma specimens, we selected the first specimen on or after their initial HBV qualifying test. All samples were tested for HDV IgG antibody and HDV RNA. Multivariable log‐binomial generalized linear models were used to estimate prevalence ratios (PRs) with 95% CIs of HDV IgG antibody‐positivity associated with determinants of interest (age, injection drug use [IDU], high‐risk sexual behaviour). Among 597 adults with HIV/HBV coinfection in CNICS and available serum/plasma samples (median age, 43 years; 89.9% male; 52.8% Black; 42.4% White), 24/597 (4.0%; 95% CI, 2.4%–5.6%) were HDV IgG antibody‐positive, and 10/596 (1.7%; 95% CI, 0.6%–2.7%) had detectable HDV RNA. In multivariable analysis, IDU was associated with exposure to HDV infection (adjusted PR = 2.50; 95% CI, 1.09–5.74). In conclusion, among a sample of adults with HIV/HBV coinfection in care in the US, 4.0% were HDV IgG antibody‐positive, among whom 41.7% had detectable HDV RNA. History of IDU was associated with exposure to HDV infection. These findings emphasize the importance of HDV testing among persons with HIV/HBV coinfection, especially those with a history of IDU.

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Molecular epidemiology and clinical characteristics of hepatitis D virus infection in Canada

Cited by 12 publications

References 44 publications

Hepatitis Delta Infection: A Clinical Review

Hepatitis Delta Infection: A Clinical Review

Anti‐HDV reflex testing in HBsAg‐positive subjects: An efficacious strategy to identify HDV infection

Prevalence and determinants of hepatitis delta virus infection among HIV/hepatitis B‐coinfected adults in care in the United States

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