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The increasing prevalence of hepatitis delta virus (HDV) infection in South London

Timothy J S Cross1, Paolo Rizzi, Mary Horner

  • 1Institute of Liver Studies, King's College Hospital, Denmark Hill, London, UK.

Journal of Medical Virology
|December 22, 2007
PubMed

Insights

Hepatitis delta virus (HDV) co-infection is more common than previously thought in the UK, particularly in South London. Testing HBV patients for HDV is crucial due to increased morbidity associated with co-infection.

Area of Science:

  • Hepatology
  • Virology
  • Infectious Diseases

Background:

  • Hepatitis delta virus (HDV) infection was historically considered rare in the UK, primarily affecting intravenous drug users.
  • Chronic hepatitis B (HBV) is a significant global health concern, and understanding co-infection patterns is vital for patient management.

Purpose of the Study:

  • To determine the current prevalence of HDV co-infection among adult patients with chronic HBV in South London.
  • To investigate transmission routes, demographic factors, and clinical outcomes associated with HDV/HBV co-infection.

Main Methods:

  • Retrospective analysis of 962 adult patients with chronic HBV infection referred to King's College Hospital from 2000 to 2006.
  • Assessment of HDV antibody status, demographic data, and potential transmission routes (including intravenous drug use and intra-familial transmission).
  • Comparison of clinical characteristics, including hepatitis C co-infection, cirrhosis, and hepatocellular carcinoma risk, between HBV mono-infected and HBV/HDV co-infected patients.

Main Results:

  • HDV antibody prevalence was 8.5% (7.1% excluding non-UK residents).
  • Most HDV-infected patients were from regions where HDV is endemic; intra-familial transmission and intravenous drug use were common routes.
  • HDV/HBV co-infected patients showed higher rates of hepatitis C co-infection and cirrhosis compared to HBV mono-infected patients, but similar hepatocellular carcinoma risk.

Conclusions:

  • HDV co-infection demonstrates a higher prevalence in South London than historically reported.
  • HDV co-infection is associated with increased morbidity, including higher rates of cirrhosis.
  • Routine testing for HDV infection in HBV patients is recommended to identify co-infected individuals and manage associated risks effectively.

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