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Per a new October 2024 study titled “Hepatitis Delta Virus Testing, Prevalence, and Liver-Related Outcomes Among US Veterans With Chronic Hepatitis B,” only 1 in 6 US veterans with chronic hepatitis B (CHB) is also tested for hepatitis D virus (HDV). HDV is a coinfection associated with measurably higher risks of cirrhosis and hepatic decompensation.
“The low testing rate suggests limited awareness of HDV-associated risks in patients with CHB, and underscores the need for earlier testing and diagnosis, lead author Robert J. Wong, MD, of Stanford University School of Medicine, Stanford, California, and colleagues, reported.
‘Data among US populations are lacking to describe the epidemiology and long-term outcomes of patients with CHB and concurrent HDV infection,’ the investigators wrote in Gastro Hep Advances (2025 Oct. doi: 10.1016/j.gastha.2024.10.015).
Prior studies have found that only 6% to 19% of patients with CHB get tested for HDV, and among those tested, the prevalence is relatively low—between 2% and 4.6%. Although relatively uncommon, HDV carries a substantial clinical and economic burden, Dr. Wong and colleagues noted, highlighting the importance of clinical awareness and accurate epidemiologic data.
The present study analyzed data from the Veterans Affairs (VA) Corporate Data Warehouse between 2010 and 2023. Adults with CHB were identified based on laboratory-confirmed markers and ICD-9/10 codes. HDV testing (anti-HDV antibody and HDV RNA) was assessed, and predictors of testing were evaluated using multivariable logistic regression.”
Hepatitis D is a severe form of viral hepatitis caused by the Hepatitis D virus (HDV). It requires the presence of Hepatitis B virus (HBV) for its replication and can cause more serious liver damage than HBV alone. HDV infection can be acute or chronic, with chronic HDV being considered the most severe form of viral hepatitis due to its faster progression to cirrhosis and liver cancer.
Key points about Hepatitis D
– Requires HBV: HDV cannot replicate without HBV, making it a “satellite virus”.
– Transmission: HDV is transmitted through blood or body fluids, similar to HBV.
– Progression: Chronic HDV infection is associated with a faster progression to liver cirrhosis and liver cancer than chronic HBV infection alone.
– Severity: HDV infection can lead to more severe liver disease, including acute liver failure, than HBV infection alone.
– Treatment: While treatment options are limited, pegylated interferon alfa and bulevirtide are used to manage HDV infection.
– Prevention: Preventing HDV infection primarily involves preventing HBV infection through vaccination.
Lead author Robert J. Wong, MD, of Stanford University School of Medicine, Stanford, California.
