Estimating the global prevalence, disease progression, and clinical outcome of hepatitis delta virus infection

Hepatitis delta virus (HDV) coinfects with hepatitis B virus (HBV) causing the most severe form of viral hepatitis. However, its exact global disease burden remains largely obscure. We aim to establish the global epidemiology, infection mode-stratified disease progression, and clinical outcome of HD...

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Main Authors: Miao, Zhijiang (Author) , Zhang, Shaoshi (Author) , Ou, Xumin (Author) , Li, Shan (Author) , Ma, Zhongren (Author) , Wang, Wenshi (Author) , Peppelenbosch, Maikel P (Author) , Liu, Jiaye (Author) , Pan, Qiuwei (Author)
Format: Article (Journal)
Language:English
Published: 2020
In: The journal of infectious diseases
Year: 2019, Volume: 221, Issue: 10, Pages: 1677-1687
ISSN:1537-6613
DOI:10.1093/infdis/jiz633
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1093/infdis/jiz633
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Author Notes:Zhijiang Miao, Shaoshi Zhang, Xumin Ou, Shan Li, Zhongren Ma, Wenshi Wang, Maikel P Peppelenbosch, Jiaye Liu, and Qiuwei Pan

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520 |a Hepatitis delta virus (HDV) coinfects with hepatitis B virus (HBV) causing the most severe form of viral hepatitis. However, its exact global disease burden remains largely obscure. We aim to establish the global epidemiology, infection mode-stratified disease progression, and clinical outcome of HDV infection.We conducted a meta-analysis with a random-effects model and performed data synthesis.The pooled prevalence of HDV is 0.80% (95% confidence interval [CI], 0.63-1.00) among the general population and 13.02% (95% CI, 11.96-14.11) among HBV carriers, corresponding to 48-60 million infections globally. Among HBV patients with fulminant hepatitis, cirrhosis, or hepatocellular carcinoma, HDV prevalence is 26.75% (95% CI, 19.84-34.29), 25.77% (95% CI, 20.62-31.27), and 19.80% (95% CI, 10.97-30.45), respectively. The odds ratio (OR) of HDV infection among HBV patients with chronic liver disease compared with asymptomatic controls is 4.55 (95% CI, 3.65-5.67). Hepatitis delta virus-coinfected patients are more likely to develop cirrhosis than HBV-monoinfected patients with OR of 3.84 (95% CI, 1.79-8.24). Overall, HDV infection progresses to cirrhosis within 5 years and to hepatocellular carcinoma within 10 years, on average.Findings suggest that HDV poses a heavy global burden with rapid progression to severe liver diseases, urging effective strategies for screening, prevention, and treatment. 
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