HDV Burden of Disease

Researchers who estimated the global prevalence of hepatitis D virus (HDV) infection found that it contributes significantly to the development of cirrhosis and hepatocellular carcinoma (HCC) among people with positive hepatitis B surface antigen (HBsAg). Their findings are reported in the Journal of Hepatology.

The investigators searched Pubmed, EMBASE, and Scopus, identifying 282 studies from 95 countries with 120,293 HBsAg-positive people who were tested for total or Immunoglobulin G (IgG) anti-HDV. They estimated the anti-HDV prevalence using a binomial mixed model and used random effects models to calculate the population attributable fraction (PAF) of HDV to cirrhosis and HCC among these patients.

The estimated prevalence of anti-HDV was 4.5% (95% CI 3.6-5.7) among all patients who were HBsAg-positive and 16.4% (14.6-18.6) among those seen at hepatology clinics. Worldwide, approximately 12.0 million people are estimated to have been infected with HDV.

The prevalence of HDV among HBsAg-positive people was highest in Mongolia, the Republic of Moldova, and countries in Western and Middle Africa. The rates of HDV infection were higher among injectable drug users, patients receiving hemodialysis, men who have sex with men, commercial sex workers, and people with hepatitis C virus and human immunodeficiency virus. Hepatitis D is estimated to contribute to about 1 in 6 of the cases of cirrhosis and 1 in 5 of the cases of liver cancer that occur in people with hepatitis B.

“HDV is a significant contributor to HBV-associated liver disease,” the authors wrote. “More quality data are needed to improve the precision of burden estimates.”

—Rebecca Mashaw

Reference:
Stockdale AJ, Kreuels B, Henrion MYR. The global prevalence of hepatitis D virus infection: Systematic review and meta-analysis. J Hepatol. 2020;73(3):523-532. DOI: 10.1016/j.jhep.2020.04.008