Recent prevalence and characteristics of patients with hepatitis delta virus in Hokkaido, Japan

Abstract

AimAlthough hepatitis delta virus (HDV) coinfection with hepatitis B virus (HBV) is a global health concern, the global prevalence of HDV infections remains unknown due to insufficient data in many countries. In Japan, HDV prevalence has not been updated for over 20 years. We aimed to investigate the recent prevalence of HDV infections in Japan.MethodsWe screened 1264 consecutive patients with HBV infection at Hokkaido University Hospital between 2006 and 2022. Patients' serums were preserved and subsequently tested for HDV antibody (immunoglobulin‐G). Available clinical information was collected and analyzed. We compared the changes in liver fibrosis using the Fibrosis‐4 (FIB‐4) index between propensity‐matched patients with and without the evidence of anti‐HDV antibodies and corrected for baseline FIB‐4 index, nucleoside/nucleotide analog treatment, alcohol intake, sex, HIV coinfection, liver cirrhosis, and age.ResultsAfter excluding patients without properly stored serums and those lacking appropriate clinical information, 601 patients with HBV were included. Of these, 1.7% of patients had detectable anti‐HDV antibodies. Patients with anti‐HDV antibody serum positivity had a significantly higher prevalence of liver cirrhosis, significantly lower prothrombin time, and a higher prevalence of HIV coinfection than those who demonstrated serum anti‐HDV antibody negativity. A propensity‐matched longitudinal analysis revealed that liver fibrosis (FIB‐4 index) progressed more rapidly in patients with positive results for anti‐HDV antibody tests.ConclusionsThe recent prevalence of HDV infections in Japanese patients with HBV was 1.7% (10/601). These patients experienced rapid liver fibrosis progression, highlighting the importance of routine HDV testing.

Diagnostic Efficacy of Serological Antibody Detection Tests for Hepatitis Delta Virus: A Systematic Review and Meta-Analysis

“…Japanese researchers have published two studies on HDV antibody screening in HBsAg seropositivity patients, and the results show that compared with seropositivity HDV patients, serum HDV antibody-positive patients have a significantly higher prevalence of cirrhosis, lower prothrombin time, higher prevalence of HIV co-infection and faster progression of liver fibrosis. This result highlights the importance of routine HDV testing [38,39]. An estimated 12 million people worldwide have had HDV infection [40], with a higher prevalence in certain geographic areas and populations.…”

Hepatitis E Virus Infection Caused Elevation of Alanine Aminotransferase Levels in a Patient with Chronic Hepatitis B and Choledocholithiasis

“…The recent recommendations [93] make the most sense in the countries with a low prevalence of HBV and those with a high prevalence of HBV and HDV. The recently measured prevalence of HDV infection in patients with HBV infection in Hokkaido, Japan, was 1.7% [94]. The patients with sera positive for the anti-HDV antibody experienced the rapid progression of liver fibrosis, suggesting the importance of routine HDV testing.…”