Hepatitis Delta Coinfection Rates and All-Cause Mortality Among Hepatitis B-Infected Veterans in the USA

Area of Science:

• Hepatology
• Infectious Diseases
• Public Health

Background:

• Hepatitis D virus (HDV) screening is recommended for all individuals with hepatitis B virus (HBV) infection due to more severe liver outcomes in coinfected patients.
• Understanding HDV testing rates, coinfection prevalence, and associated mortality is crucial for managing HBV patients.

Purpose of the Study:

• To determine HDV testing and coinfection rates among HBV-infected individuals.
• To assess all-cause mortality stratified by HDV coinfection and HBV treatment status.

Main Methods:

• Retrospective analysis of US Department of Veterans Affairs national databases.
• Identification of individuals with HBV infection (HBsAg, HBeAg, or HBV DNA positive).
• Calculation of HDV screening, positive test rates, HBV treatment rates, and all-cause mortality.

Main Results:

• Only 13.3% of HBV-infected individuals were screened for HDV; 3.0% tested positive.
• HDV coinfection was associated with significantly higher all-cause mortality (5.14 per 100 person-years) compared to HDV-uninfected individuals (2.98 per 100 person-years).
• HBV treatment showed a survival benefit, particularly for HDV-coinfected individuals (mortality reduced from 5.14 to 3.0 per 100 person-years).

Conclusions:

• HDV screening rates among HBV-infected individuals are suboptimal.
• HDV coinfection significantly increases all-cause mortality.
• Treatment for HBV may offer a survival advantage for coinfected patients, highlighting the need for improved screening and management strategies.