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Characterizing Hepatitis Delta in Spain and the gaps in its management
Sergio Rodríguez-Tajes1, Adriana Palom2, Álvaro Giráldez-Gallego3
1Hospital Clínic, Universitat de Barcelona, IDIBAPS, CIBEREHD, Barcelona, Spain.
Gastroenterologia Y Hepatologia
|June 22, 2024
Summary
Chronic hepatitis D (CHD) patients often have cirrhosis at diagnosis. Persistent hepatitis delta virus (HDV) viremia accelerates liver disease progression, highlighting management challenges before new therapies.
Area of Science:
- Hepatology
- Virology
- Clinical Medicine
Background:
- Chronic hepatitis D (CHD) is a severe liver disease.
- Hepatitis delta virus (HDV) affects approximately 5% of hepatitis B virus (HBV) patients in Spain.
- New antiviral therapies like Bulevirtide (BLV) faced reimbursement delays in Spain until February 2024.
Purpose of the Study:
- To characterize the clinical profile of patients with HDV/HBV infection in Spain.
- To identify management barriers for CHD patients prior to BLV approval.
Main Methods:
- A multicenter registry study was conducted across 30 Spanish centers.
- Data on epidemiological, clinical, and virological variables were collected.
- Patients with positive anti-HDV serology were actively monitored.
Main Results:
- 329 anti-HDV patients were identified; 33% had cirrhosis at diagnosis.
- Persistent HDV viremia was linked to a higher prevalence of cirrhosis (58% vs 25%).
- During follow-up, 10% developed cirrhosis, with progression associated with viremia. Barriers in HDV-RNA quantification were noted.
Conclusions:
- A significant proportion of CHD patients present with cirrhosis at diagnosis.
- Sustained HDV viremia is a key factor in rapid liver disease progression.
- Challenges in local HDV-RNA testing posed management barriers.
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