Adjusted estimate of the prevalence of hepatitis delta virus in 25 countries and territories

Devin M. Razavi-Shearer; Maria Buti; Frank Tacke; Norah A. Terrault; Stefan Zeuzem; Zaigham Abbas; Alessio Aghemo; Ulus S. Akarca; Nasser M. Al Masri; Abduljaleel M. Alalwan; Marianne Alanko Blome; Soo Aleman; Abdullah S. Alghamdi; Mohammed Alghamdi; Saad Alghamdi; Waleed K. Al-Hamoudi; Ela Ali; Abdulrahman A. Aljumah; Ibrahim H. Altraif; Jazag Amarsanaa; Tarik Asselah; Oidov Baatarkhuu; Adriana Babameto; Ziv Ben-Ari; Thomas Berg; Mia J. Biondi; Wornei S. M. Braga; Carlos E. Brandao-Mello; Robert S. Brown Jr; Maurizia R. Brunetto; Joaquin Cabezas; Mariana Cardoso; Henry Lik Yuen Chan; Hugo Cheinquer; Chien-Jen Chen; Pei-Jer Chen; Cheng-Hung Chien; Hailey Child; Wan-Long Chuang; Laura E. Cisneros Garza; Barbara Coco; Carla S. Coffin; Nicola Coppola; Markus Cornberg; Antonio Craxi; Javier Crespo; Liri Cuko; Victor De Ledinghen; Ann-Sofi Duberg; Sofia Ribeiro; Et al.

doi:10.1016/j.jhep.2023.10.043

Adjusted estimate of the prevalence of hepatitis delta virus in 25 countries and territories

Devin M. Razavi-Shearer^*, Maria Buti, Frank Tacke, Norah A. Terrault, Stefan Zeuzem, Zaigham Abbas, Alessio Aghemo, Ulus S. Akarca, Nasser M. Al Masri, Abduljaleel M. Alalwan, Marianne Alanko Blome, Soo Aleman, Abdullah S. Alghamdi, Mohammed Alghamdi, Saad Alghamdi, Waleed K. Al-Hamoudi, Ela Ali, Abdulrahman A. Aljumah, Ibrahim H. Altraif, Jazag AmarsanaaTarik Asselah, Oidov Baatarkhuu, Adriana Babameto, Ziv Ben-Ari, Thomas Berg, Mia J. Biondi, Wornei S. M. Braga, Carlos E. Brandao-Mello, Robert S. Brown Jr, Maurizia R. Brunetto, Joaquin Cabezas, Mariana Cardoso, Henry Lik Yuen Chan, Hugo Cheinquer, Chien-Jen Chen, Pei-Jer Chen, Cheng-Hung Chien, Hailey Child, Wan-Long Chuang, Laura E. Cisneros Garza, Barbara Coco, Carla S. Coffin, Nicola Coppola, Markus Cornberg, Antonio Craxi, Javier Crespo, Liri Cuko, Victor De Ledinghen, Ann-Sofi Duberg, Sofia Ribeiro, Et al.

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Background & Aims: Hepatitis delta virus (HDV) is a satellite RNA virus that requires the hepatitis B virus (HBV) for assembly and propagation. Individuals infected with HDV progress to advanced liver disease faster than HBV-monoinfected individuals. Recent studies have estimated the global prevalence of anti-HDV antibodies among the HBV-infected population to be 5-15%. This study aimed to better understand HDV prevalence at the population level in 25 countries/territories. Methods: We conducted a literature review to determine the prevalence of anti-HDV and HDV RNA in hepatitis B surface antigen (HBsAg)-positive individuals in 25 countries/territories. Virtual meetings were held with experts from each setting to discuss the findings and collect unpublished data. Data were weighted for patient segments and regional heterogeneity to estimate the prevalence in the HBV-infected population. The findings were then combined with The Polaris Observatory HBV data to estimate the anti-HDV and HDV RNA prevalence in each country/territory at the population level. Results: After adjusting for geographical distribution, disease stage and special populations, the anti-HDV prevalence among the HBsAg+ population changed from the literature estimate in 19 countries. The highest anti-HDV prevalence was 60.1% in Mongolia. Once adjusted for the size of the HBsAg+ population and HDV RNA positivity rate, China had the highest absolute number of HDV RNA+ cases. Conclusions: We found substantially lower HDV prevalence than previously reported, as prior meta-analyses primarily focused on studies conducted in groups/regions that have a higher probability of HBV infection: tertiary care centers, specific risk groups or geographical regions. There is large uncertainty in HDV prevalence estimates. The implementation of reflex testing would improve estimates, while also allowing earlier linkage to care for HDV RNA+ individuals. The logistical and economic burden of reflex testing on the health system would be limited, as only HBsAg+ cases would be screened.

Original language	English
Pages (from-to)	232-242
Number of pages	11
Journal	Journal of Hepatology
Volume	80
Issue number	2
DOIs	https://doi.org/10.1016/j.jhep.2023.10.043
Publication status	Published - 1 Feb 2024

Keywords

NUTRITION EXAMINATION SURVEY
B-VIRUS
RISK-FACTORS
NATIONAL-HEALTH
DRUG-USERS
INFECTION
SEROPREVALENCE
EPIDEMIOLOGY
ANTIBODY

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10.1016/j.jhep.2023.10.043Licence: CC BY-NC-ND

Cite this

Razavi-Shearer, D. M., Buti, M., Tacke, F., Terrault, N. A., Zeuzem, S., Abbas, Z., Aghemo, A., Akarca, U. S., Al Masri, N. M., Alalwan, A. M., Blome, M. A., Aleman, S., Alghamdi, A. S., Alghamdi, M., Alghamdi, S., Al-Hamoudi, W. K., Ali, E., Aljumah, A. A., Altraif, I. H., ... Et al. (2024). Adjusted estimate of the prevalence of hepatitis delta virus in 25 countries and territories. Journal of Hepatology, 80(2), 232-242. https://doi.org/10.1016/j.jhep.2023.10.043

@article{19d70012054044469b11173e06925c78,

title = "Adjusted estimate of the prevalence of hepatitis delta virus in 25 countries and territories",

abstract = "Background & Aims: Hepatitis delta virus (HDV) is a satellite RNA virus that requires the hepatitis B virus (HBV) for assembly and propagation. Individuals infected with HDV progress to advanced liver disease faster than HBV-monoinfected individuals. Recent studies have estimated the global prevalence of anti-HDV antibodies among the HBV-infected population to be 5-15%. This study aimed to better understand HDV prevalence at the population level in 25 countries/territories. Methods: We conducted a literature review to determine the prevalence of anti-HDV and HDV RNA in hepatitis B surface antigen (HBsAg)-positive individuals in 25 countries/territories. Virtual meetings were held with experts from each setting to discuss the findings and collect unpublished data. Data were weighted for patient segments and regional heterogeneity to estimate the prevalence in the HBV-infected population. The findings were then combined with The Polaris Observatory HBV data to estimate the anti-HDV and HDV RNA prevalence in each country/territory at the population level. Results: After adjusting for geographical distribution, disease stage and special populations, the anti-HDV prevalence among the HBsAg+ population changed from the literature estimate in 19 countries. The highest anti-HDV prevalence was 60.1% in Mongolia. Once adjusted for the size of the HBsAg+ population and HDV RNA positivity rate, China had the highest absolute number of HDV RNA+ cases. Conclusions: We found substantially lower HDV prevalence than previously reported, as prior meta-analyses primarily focused on studies conducted in groups/regions that have a higher probability of HBV infection: tertiary care centers, specific risk groups or geographical regions. There is large uncertainty in HDV prevalence estimates. The implementation of reflex testing would improve estimates, while also allowing earlier linkage to care for HDV RNA+ individuals. The logistical and economic burden of reflex testing on the health system would be limited, as only HBsAg+ cases would be screened.",

keywords = "NUTRITION EXAMINATION SURVEY, B-VIRUS, RISK-FACTORS, NATIONAL-HEALTH, DRUG-USERS, INFECTION, SEROPREVALENCE, EPIDEMIOLOGY, ANTIBODY",

author = "Razavi-Shearer, {Devin M.} and Maria Buti and Frank Tacke and Terrault, {Norah A.} and Stefan Zeuzem and Zaigham Abbas and Alessio Aghemo and Akarca, {Ulus S.} and {Al Masri}, {Nasser M.} and Alalwan, {Abduljaleel M.} and Blome, {Marianne Alanko} and Soo Aleman and Alghamdi, {Abdullah S.} and Mohammed Alghamdi and Saad Alghamdi and Al-Hamoudi, {Waleed K.} and Ela Ali and Aljumah, {Abdulrahman A.} and Altraif, {Ibrahim H.} and Jazag Amarsanaa and Tarik Asselah and Oidov Baatarkhuu and Adriana Babameto and Ziv Ben-Ari and Thomas Berg and Biondi, {Mia J.} and Braga, {Wornei S. M.} and Brandao-Mello, {Carlos E.} and Jr, {Robert S. Brown} and Brunetto, {Maurizia R.} and Joaquin Cabezas and Mariana Cardoso and Chan, {Henry Lik Yuen} and Hugo Cheinquer and Chien-Jen Chen and Pei-Jer Chen and Cheng-Hung Chien and Hailey Child and Wan-Long Chuang and Garza, {Laura E. Cisneros} and Barbara Coco and Coffin, {Carla S.} and Nicola Coppola and Markus Cornberg and Antonio Craxi and Javier Crespo and Liri Cuko and {De Ledinghen}, Victor and Ann-Sofi Duberg and Sofia Ribeiro and {Et al.}",

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doi = "10.1016/j.jhep.2023.10.043",

language = "English",

volume = "80",

pages = "232--242",

journal = "Journal of Hepatology",

issn = "0168-8278",

publisher = "Elsevier Science",

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Razavi-Shearer, DM, Buti, M, Tacke, F, Terrault, NA, Zeuzem, S, Abbas, Z, Aghemo, A, Akarca, US, Al Masri, NM, Alalwan, AM, Blome, MA, Aleman, S, Alghamdi, AS, Alghamdi, M, Alghamdi, S, Al-Hamoudi, WK, Ali, E, Aljumah, AA, Altraif, IH, Amarsanaa, J, Asselah, T, Baatarkhuu, O, Babameto, A, Ben-Ari, Z, Berg, T, Biondi, MJ, Braga, WSM, Brandao-Mello, CE, Jr, RSB, Brunetto, MR, Cabezas, J, Cardoso, M, Chan, HLY, Cheinquer, H, Chen, C-J, Chen, P-J, Chien, C-H, Child, H, Chuang, W-L, Garza, LEC, Coco, B, Coffin, CS, Coppola, N, Cornberg, M, Craxi, A, Crespo, J, Cuko, L, De Ledinghen, V, Duberg, A-S, Ribeiro, S & Et al. 2024, 'Adjusted estimate of the prevalence of hepatitis delta virus in 25 countries and territories', Journal of Hepatology, vol. 80, no. 2, pp. 232-242. https://doi.org/10.1016/j.jhep.2023.10.043

TY - JOUR

T1 - Adjusted estimate of the prevalence of hepatitis delta virus in 25 countries and territories

AU - Razavi-Shearer, Devin M.

AU - Buti, Maria

AU - Tacke, Frank

AU - Terrault, Norah A.

AU - Zeuzem, Stefan

AU - Abbas, Zaigham

AU - Aghemo, Alessio

AU - Akarca, Ulus S.

AU - Al Masri, Nasser M.

AU - Alalwan, Abduljaleel M.

AU - Blome, Marianne Alanko

AU - Aleman, Soo

AU - Alghamdi, Abdullah S.

AU - Alghamdi, Mohammed

AU - Alghamdi, Saad

AU - Al-Hamoudi, Waleed K.

AU - Ali, Ela

AU - Aljumah, Abdulrahman A.

AU - Altraif, Ibrahim H.

AU - Amarsanaa, Jazag

AU - Asselah, Tarik

AU - Baatarkhuu, Oidov

AU - Babameto, Adriana

AU - Ben-Ari, Ziv

AU - Berg, Thomas

AU - Biondi, Mia J.

AU - Braga, Wornei S. M.

AU - Brandao-Mello, Carlos E.

AU - Jr, Robert S. Brown

AU - Brunetto, Maurizia R.

AU - Cabezas, Joaquin

AU - Cardoso, Mariana

AU - Chan, Henry Lik Yuen

AU - Cheinquer, Hugo

AU - Chen, Chien-Jen

AU - Chen, Pei-Jer

AU - Chien, Cheng-Hung

AU - Child, Hailey

AU - Chuang, Wan-Long

AU - Garza, Laura E. Cisneros

AU - Coco, Barbara

AU - Coffin, Carla S.

AU - Coppola, Nicola

AU - Cornberg, Markus

AU - Craxi, Antonio

AU - Crespo, Javier

AU - Cuko, Liri

AU - De Ledinghen, Victor

AU - Duberg, Ann-Sofi

AU - Ribeiro, Sofia

AU - Et al.

PY - 2024/2/1

Y1 - 2024/2/1

N2 - Background & Aims: Hepatitis delta virus (HDV) is a satellite RNA virus that requires the hepatitis B virus (HBV) for assembly and propagation. Individuals infected with HDV progress to advanced liver disease faster than HBV-monoinfected individuals. Recent studies have estimated the global prevalence of anti-HDV antibodies among the HBV-infected population to be 5-15%. This study aimed to better understand HDV prevalence at the population level in 25 countries/territories. Methods: We conducted a literature review to determine the prevalence of anti-HDV and HDV RNA in hepatitis B surface antigen (HBsAg)-positive individuals in 25 countries/territories. Virtual meetings were held with experts from each setting to discuss the findings and collect unpublished data. Data were weighted for patient segments and regional heterogeneity to estimate the prevalence in the HBV-infected population. The findings were then combined with The Polaris Observatory HBV data to estimate the anti-HDV and HDV RNA prevalence in each country/territory at the population level. Results: After adjusting for geographical distribution, disease stage and special populations, the anti-HDV prevalence among the HBsAg+ population changed from the literature estimate in 19 countries. The highest anti-HDV prevalence was 60.1% in Mongolia. Once adjusted for the size of the HBsAg+ population and HDV RNA positivity rate, China had the highest absolute number of HDV RNA+ cases. Conclusions: We found substantially lower HDV prevalence than previously reported, as prior meta-analyses primarily focused on studies conducted in groups/regions that have a higher probability of HBV infection: tertiary care centers, specific risk groups or geographical regions. There is large uncertainty in HDV prevalence estimates. The implementation of reflex testing would improve estimates, while also allowing earlier linkage to care for HDV RNA+ individuals. The logistical and economic burden of reflex testing on the health system would be limited, as only HBsAg+ cases would be screened.

AB - Background & Aims: Hepatitis delta virus (HDV) is a satellite RNA virus that requires the hepatitis B virus (HBV) for assembly and propagation. Individuals infected with HDV progress to advanced liver disease faster than HBV-monoinfected individuals. Recent studies have estimated the global prevalence of anti-HDV antibodies among the HBV-infected population to be 5-15%. This study aimed to better understand HDV prevalence at the population level in 25 countries/territories. Methods: We conducted a literature review to determine the prevalence of anti-HDV and HDV RNA in hepatitis B surface antigen (HBsAg)-positive individuals in 25 countries/territories. Virtual meetings were held with experts from each setting to discuss the findings and collect unpublished data. Data were weighted for patient segments and regional heterogeneity to estimate the prevalence in the HBV-infected population. The findings were then combined with The Polaris Observatory HBV data to estimate the anti-HDV and HDV RNA prevalence in each country/territory at the population level. Results: After adjusting for geographical distribution, disease stage and special populations, the anti-HDV prevalence among the HBsAg+ population changed from the literature estimate in 19 countries. The highest anti-HDV prevalence was 60.1% in Mongolia. Once adjusted for the size of the HBsAg+ population and HDV RNA positivity rate, China had the highest absolute number of HDV RNA+ cases. Conclusions: We found substantially lower HDV prevalence than previously reported, as prior meta-analyses primarily focused on studies conducted in groups/regions that have a higher probability of HBV infection: tertiary care centers, specific risk groups or geographical regions. There is large uncertainty in HDV prevalence estimates. The implementation of reflex testing would improve estimates, while also allowing earlier linkage to care for HDV RNA+ individuals. The logistical and economic burden of reflex testing on the health system would be limited, as only HBsAg+ cases would be screened.

KW - NUTRITION EXAMINATION SURVEY

KW - B-VIRUS

KW - RISK-FACTORS

KW - NATIONAL-HEALTH

KW - DRUG-USERS

KW - INFECTION

KW - SEROPREVALENCE

KW - EPIDEMIOLOGY

KW - ANTIBODY

U2 - 10.1016/j.jhep.2023.10.043

DO - 10.1016/j.jhep.2023.10.043

M3 - Article

SN - 0168-8278

VL - 80

SP - 232

EP - 242

JO - Journal of Hepatology

JF - Journal of Hepatology

IS - 2

ER -