Hepatitis D double reflex testing of all hepatitis B carriers in low-HBV- and high-HBV/HDV-prevalence countries
Journal
Journal of Hepatology
Date Issued
2023-01-01
Author(s)
Razavi, Homie A.
Buti, Maria
Terrault, Norah A.
Zeuzem, Stefan
Yurdaydin, Cihan
Tanaka, Junko
Aghemo, Alessio
Akarca, Ulus S.
Al Masri, Nasser M.
Alalwan, Abduljaleel M.
Aleman, Soo
Alghamdi, Abdullah S.
Alghamdi, Saad
Al-Hamoudi, Waleed K.
Aljumah, Abdulrahman A.
Altraif, Ibrahim H.
Asselah, Tarik
Ben-Ari, Ziv
Berg, Thomas
Biondi, Mia J.
Blach, Sarah
Braga, Wornei S.M.
Brandão-Mello, Carlos E.
Brunetto, Maurizia R.
Cabezas, Joaquin
Cheinquer, Hugo
Cheon, Myeong Eun
Chuang, Wan Long
Coffin, Carla S.
Coppola, Nicola
Craxi, Antonio
Crespo, Javier
De Ledinghen, Victor
Duberg, Ann Sofi
Etzion, Ohad
Ferraz, Maria Lucia G.
Ferreira, Paulo R.A.
Forns, Xavier
Foster, Graham R.
Gaeta, Giovanni B.
Gamkrelidze, Ivane
García-Samaniego, Javier
Gheorghe, Liliana S.
Gholam, Pierre M.
Gish, Robert G.
Glenn, Jeffrey
Hercun, Julian
Hsu, Yao Chun
Hu, Ching Chih
Huang, Jee Fu
Janjua, Naveed
Jia, Jidong
Kåberg, Martin
Kaita, Kelly D.E.
Kamal, Habiba
Kondili, Loreta A.
Lagging, Martin
Lázaro, Pablo
Lazarus, Jeffrey V.
Lee, Mei Hsuan
Lim, Young Suk
Marotta, Paul J.
Navas, Maria Cristina
Naveira, Marcelo C.M.
Orrego, Mauricio
Osiowy, Carla
Pan, Calvin Q.
Pessoa, Mário G.
Raimondo, Giovanni
Ramji, Alnoor
Razavi-Shearer, Devin M.
Razavi-Shearer, Kathryn
Ríos-Hincapié, Cielo Y.
Rodríguez, Manuel
Rosenberg, William M.C.
Roulot, Dominique M.
Ryder, Stephen D.
Safadi, Rifaat
Sanai, Faisal M.
Santantonio, Teresa A.
Sarrazin, Christoph
Shouval, Daniel
Tacke, Frank
Tergast, Tammo L.
Villalobos-Salcedo, Juan Miguel
Voeller, Alexis S.
Yang, Hwai I.
Yu, Ming Lung
Zuckerman, Eli
Abstract
Hepatitis D virus (HDV) infection occurs as a coinfection with hepatitis B and increases the risk of hepatocellular carcinoma, decompensated cirrhosis, and mortality compared to hepatitis B virus (HBV) monoinfection. Reliable estimates of the prevalence of HDV infection and disease burden are essential to formulate strategies to find coinfected individuals more effectively and efficiently. The global prevalence of HBV infections was estimated to be 262,240,000 in 2021. Only 1,994,000 of the HBV infections were newly diagnosed in 2021, with more than half of the new diagnoses made in China. Our initial estimates indicated a much lower prevalence of HDV antibody (anti-HDV) and HDV RNA positivity than previously reported in published studies. Accurate estimates of HDV prevalence are needed. The most effective method to generate estimates of the prevalence of anti-HDV and HDV RNA positivity and to find undiagnosed individuals at the national level is to implement double reflex testing. This requires anti-HDV testing of all hepatitis B surface antigen-positive individuals and HDV RNA testing of all anti-HDV-positive individuals. This strategy is manageable for healthcare systems since the number of newly diagnosed HBV cases is low. At the global level, a comprehensive HDV screening strategy would require only 1,994,000 HDV antibody tests and less than 89,000 HDV PCR tests. Double reflex testing is the preferred strategy in countries with a low prevalence of HBV and those with a high prevalence of both HBV and HDV. For example, in the European Union and North America only 35,000 and 22,000 cases, respectively, will require anti-HDV testing annually.
Subjects
HDV | Hepatitis D virus
SDGs
Type
other