The global prevalence of hepatitis D virus infection: Systematic review and meta-analysis
There are uncertainties about the epidemic patterns of HDV infection and its contribution to the burden of liver disease. We estimated the global prevalence of HDV infection and explored its contribution to the development of cirrhosis and hepatocellular carcinoma (HCC) among HBsAg-positive people....
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| Published in: | Journal of hepatology Vol. 73; no. 3; pp. 523 - 532 |
|---|---|
| Main Authors: | , , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
Netherlands
Elsevier B.V
01.09.2020
Elsevier |
| Subjects: | |
| ISSN: | 0168-8278, 1600-0641, 1600-0641 |
| Online Access: | Get full text |
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| Abstract | There are uncertainties about the epidemic patterns of HDV infection and its contribution to the burden of liver disease. We estimated the global prevalence of HDV infection and explored its contribution to the development of cirrhosis and hepatocellular carcinoma (HCC) among HBsAg-positive people.
We searched Pubmed, EMBASE and Scopus for studies reporting on total or IgG anti-HDV among HBsAg-positive people. Anti-HDV prevalence was estimated using a binomial mixed model, weighting for study quality and population size. The population attributable fraction (PAF) of HDV to cirrhosis and HCC among HBsAg-positive people was estimated using random effects models.
We included 282 studies, comprising 376 population samples from 95 countries, which together tested 120,293 HBsAg-positive people for anti-HDV. The estimated anti-HDV prevalence was 4.5% (95% CI 3.6–5.7) among all HBsAg-positive people and 16.4% (14.6–18.6) among those attending hepatology clinics. Worldwide, 0.16% (0.11–0.25) of the general population, totalling 12.0 (8.7–18.7) million people, were estimated to be anti-HDV positive. Prevalence among HBsAg-positive people was highest in Mongolia, the Republic of Moldova and countries in Western and Middle Africa, and was higher in injecting drug users, haemodialysis recipients, men who have sex with men, commercial sex workers, and those with HCV or HIV. Among HBsAg-positive people, preliminary PAF estimates of HDV were 18% (10–26) for cirrhosis and 20% (8–33) for HCC.
An estimated 12 million people worldwide have experienced HDV infection, with higher prevalence in certain geographic areas and populations. HDV is a significant contributor to HBV-associated liver disease. More quality data are needed to improve the precision of burden estimates.
We combined all available studies to estimate how many people with hepatitis B also have hepatitis D, a viral infection that only affects people with hepatitis B. About 1 in 22 people with hepatitis B also have hepatitis D, increasing to 1 in 6 when considering people with liver disease. Hepatitis D may cause about 1 in 6 of the cases of cirrhosis and 1 in 5 of the cases of liver cancer that occur in people with hepatitis B. Hepatitis D is an important contributor to the global burden of liver disease.
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•HDV infection is common among HBsAg-positive people worldwide.•Among HBsAg-positive people, estimated HDV prevalence is 4.5% (95% CI 3.6–5.7).•HDV prevalence in HBsAg-positive hepatology clinic attendees is 16.4% (14.6–18.6).•HDV prevalence is higher in people who inject drugs and who have HCV or HIV.•HDV causes an estimated 18% of cirrhosis and 20% of HCC associated with hepatitis B. |
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| AbstractList | There are uncertainties about the epidemic patterns of HDV infection and its contribution to the burden of liver disease. We estimated the global prevalence of HDV infection and explored its contribution to the development of cirrhosis and hepatocellular carcinoma (HCC) among HBsAg-positive people.
We searched Pubmed, EMBASE and Scopus for studies reporting on total or IgG anti-HDV among HBsAg-positive people. Anti-HDV prevalence was estimated using a binomial mixed model, weighting for study quality and population size. The population attributable fraction (PAF) of HDV to cirrhosis and HCC among HBsAg-positive people was estimated using random effects models.
We included 282 studies, comprising 376 population samples from 95 countries, which together tested 120,293 HBsAg-positive people for anti-HDV. The estimated anti-HDV prevalence was 4.5% (95% CI 3.6-5.7) among all HBsAg-positive people and 16.4% (14.6-18.6) among those attending hepatology clinics. Worldwide, 0.16% (0.11-0.25) of the general population, totalling 12.0 (8.7-18.7) million people, were estimated to be anti-HDV positive. Prevalence among HBsAg-positive people was highest in Mongolia, the Republic of Moldova and countries in Western and Middle Africa, and was higher in injecting drug users, haemodialysis recipients, men who have sex with men, commercial sex workers, and those with HCV or HIV. Among HBsAg-positive people, preliminary PAF estimates of HDV were 18% (10-26) for cirrhosis and 20% (8-33) for HCC.
An estimated 12 million people worldwide have experienced HDV infection, with higher prevalence in certain geographic areas and populations. HDV is a significant contributor to HBV-associated liver disease. More quality data are needed to improve the precision of burden estimates.
We combined all available studies to estimate how many people with hepatitis B also have hepatitis D, a viral infection that only affects people with hepatitis B. About 1 in 22 people with hepatitis B also have hepatitis D, increasing to 1 in 6 when considering people with liver disease. Hepatitis D may cause about 1 in 6 of the cases of cirrhosis and 1 in 5 of the cases of liver cancer that occur in people with hepatitis B. Hepatitis D is an important contributor to the global burden of liver disease. There are uncertainties about the epidemic patterns of HDV infection and its contribution to the burden of liver disease. We estimated the global prevalence of HDV infection and explored its contribution to the development of cirrhosis and hepatocellular carcinoma (HCC) among HBsAg-positive people.BACKGROUND AND AIMSThere are uncertainties about the epidemic patterns of HDV infection and its contribution to the burden of liver disease. We estimated the global prevalence of HDV infection and explored its contribution to the development of cirrhosis and hepatocellular carcinoma (HCC) among HBsAg-positive people.We searched Pubmed, EMBASE and Scopus for studies reporting on total or IgG anti-HDV among HBsAg-positive people. Anti-HDV prevalence was estimated using a binomial mixed model, weighting for study quality and population size. The population attributable fraction (PAF) of HDV to cirrhosis and HCC among HBsAg-positive people was estimated using random effects models.METHODSWe searched Pubmed, EMBASE and Scopus for studies reporting on total or IgG anti-HDV among HBsAg-positive people. Anti-HDV prevalence was estimated using a binomial mixed model, weighting for study quality and population size. The population attributable fraction (PAF) of HDV to cirrhosis and HCC among HBsAg-positive people was estimated using random effects models.We included 282 studies, comprising 376 population samples from 95 countries, which together tested 120,293 HBsAg-positive people for anti-HDV. The estimated anti-HDV prevalence was 4.5% (95% CI 3.6-5.7) among all HBsAg-positive people and 16.4% (14.6-18.6) among those attending hepatology clinics. Worldwide, 0.16% (0.11-0.25) of the general population, totalling 12.0 (8.7-18.7) million people, were estimated to be anti-HDV positive. Prevalence among HBsAg-positive people was highest in Mongolia, the Republic of Moldova and countries in Western and Middle Africa, and was higher in injecting drug users, haemodialysis recipients, men who have sex with men, commercial sex workers, and those with HCV or HIV. Among HBsAg-positive people, preliminary PAF estimates of HDV were 18% (10-26) for cirrhosis and 20% (8-33) for HCC.RESULTSWe included 282 studies, comprising 376 population samples from 95 countries, which together tested 120,293 HBsAg-positive people for anti-HDV. The estimated anti-HDV prevalence was 4.5% (95% CI 3.6-5.7) among all HBsAg-positive people and 16.4% (14.6-18.6) among those attending hepatology clinics. Worldwide, 0.16% (0.11-0.25) of the general population, totalling 12.0 (8.7-18.7) million people, were estimated to be anti-HDV positive. Prevalence among HBsAg-positive people was highest in Mongolia, the Republic of Moldova and countries in Western and Middle Africa, and was higher in injecting drug users, haemodialysis recipients, men who have sex with men, commercial sex workers, and those with HCV or HIV. Among HBsAg-positive people, preliminary PAF estimates of HDV were 18% (10-26) for cirrhosis and 20% (8-33) for HCC.An estimated 12 million people worldwide have experienced HDV infection, with higher prevalence in certain geographic areas and populations. HDV is a significant contributor to HBV-associated liver disease. More quality data are needed to improve the precision of burden estimates.CONCLUSIONSAn estimated 12 million people worldwide have experienced HDV infection, with higher prevalence in certain geographic areas and populations. HDV is a significant contributor to HBV-associated liver disease. More quality data are needed to improve the precision of burden estimates.We combined all available studies to estimate how many people with hepatitis B also have hepatitis D, a viral infection that only affects people with hepatitis B. About 1 in 22 people with hepatitis B also have hepatitis D, increasing to 1 in 6 when considering people with liver disease. Hepatitis D may cause about 1 in 6 of the cases of cirrhosis and 1 in 5 of the cases of liver cancer that occur in people with hepatitis B. Hepatitis D is an important contributor to the global burden of liver disease.LAY SUMMARYWe combined all available studies to estimate how many people with hepatitis B also have hepatitis D, a viral infection that only affects people with hepatitis B. About 1 in 22 people with hepatitis B also have hepatitis D, increasing to 1 in 6 when considering people with liver disease. Hepatitis D may cause about 1 in 6 of the cases of cirrhosis and 1 in 5 of the cases of liver cancer that occur in people with hepatitis B. Hepatitis D is an important contributor to the global burden of liver disease. There are uncertainties about the epidemic patterns of HDV infection and its contribution to the burden of liver disease. We estimated the global prevalence of HDV infection and explored its contribution to the development of cirrhosis and hepatocellular carcinoma (HCC) among HBsAg-positive people. We searched Pubmed, EMBASE and Scopus for studies reporting on total or IgG anti-HDV among HBsAg-positive people. Anti-HDV prevalence was estimated using a binomial mixed model, weighting for study quality and population size. The population attributable fraction (PAF) of HDV to cirrhosis and HCC among HBsAg-positive people was estimated using random effects models. We included 282 studies, comprising 376 population samples from 95 countries, which together tested 120,293 HBsAg-positive people for anti-HDV. The estimated anti-HDV prevalence was 4.5% (95% CI 3.6–5.7) among all HBsAg-positive people and 16.4% (14.6–18.6) among those attending hepatology clinics. Worldwide, 0.16% (0.11–0.25) of the general population, totalling 12.0 (8.7–18.7) million people, were estimated to be anti-HDV positive. Prevalence among HBsAg-positive people was highest in Mongolia, the Republic of Moldova and countries in Western and Middle Africa, and was higher in injecting drug users, haemodialysis recipients, men who have sex with men, commercial sex workers, and those with HCV or HIV. Among HBsAg-positive people, preliminary PAF estimates of HDV were 18% (10–26) for cirrhosis and 20% (8–33) for HCC. An estimated 12 million people worldwide have experienced HDV infection, with higher prevalence in certain geographic areas and populations. HDV is a significant contributor to HBV-associated liver disease. More quality data are needed to improve the precision of burden estimates. We combined all available studies to estimate how many people with hepatitis B also have hepatitis D, a viral infection that only affects people with hepatitis B. About 1 in 22 people with hepatitis B also have hepatitis D, increasing to 1 in 6 when considering people with liver disease. Hepatitis D may cause about 1 in 6 of the cases of cirrhosis and 1 in 5 of the cases of liver cancer that occur in people with hepatitis B. Hepatitis D is an important contributor to the global burden of liver disease. [Display omitted] •HDV infection is common among HBsAg-positive people worldwide.•Among HBsAg-positive people, estimated HDV prevalence is 4.5% (95% CI 3.6–5.7).•HDV prevalence in HBsAg-positive hepatology clinic attendees is 16.4% (14.6–18.6).•HDV prevalence is higher in people who inject drugs and who have HCV or HIV.•HDV causes an estimated 18% of cirrhosis and 20% of HCC associated with hepatitis B. • HDV infection is common among HBsAg-positive people worldwide. • Among HBsAg-positive people, estimated HDV prevalence is 4.5% (95% CI 3.6–5.7). • HDV prevalence in HBsAg-positive hepatology clinic attendees is 16.4% (14.6–18.6). • HDV prevalence is higher in people who inject drugs and who have HCV or HIV. • HDV causes an estimated 18% of cirrhosis and 20% of HCC associated with hepatitis B. |
| Author | Henrion, Marc Y.R. Giorgi, Emanuele Stockdale, Alexander J. Kyomuhangi, Irene de Martel, Catherine Hutin, Yvan Geretti, Anna Maria Kreuels, Benno |
| Author_xml | – sequence: 1 givenname: Alexander J. orcidid: 0000-0002-5828-3328 surname: Stockdale fullname: Stockdale, Alexander J. organization: Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom – sequence: 2 givenname: Benno orcidid: 0000-0003-2315-8954 surname: Kreuels fullname: Kreuels, Benno organization: College of Medicine, Blantyre, Malawi – sequence: 3 givenname: Marc Y.R. orcidid: 0000-0003-1242-839X surname: Henrion fullname: Henrion, Marc Y.R. organization: Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi – sequence: 4 givenname: Emanuele orcidid: 0000-0003-0640-181X surname: Giorgi fullname: Giorgi, Emanuele organization: Centre for Health Informatics, Computing, and Statistics, University of Lancaster, Lancaster, United Kingdom – sequence: 5 givenname: Irene orcidid: 0000-0002-2797-015X surname: Kyomuhangi fullname: Kyomuhangi, Irene organization: Centre for Health Informatics, Computing, and Statistics, University of Lancaster, Lancaster, United Kingdom – sequence: 6 givenname: Catherine orcidid: 0000-0002-3642-277X surname: de Martel fullname: de Martel, Catherine organization: International Agency for Research on Cancer, Lyon, France – sequence: 7 givenname: Yvan surname: Hutin fullname: Hutin, Yvan organization: World Health Organization, Geneva, Switzerland – sequence: 8 givenname: Anna Maria surname: Geretti fullname: Geretti, Anna Maria email: geretti@liverpool.ac.uk organization: Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/32335166$$D View this record in MEDLINE/PubMed |
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| Snippet | There are uncertainties about the epidemic patterns of HDV infection and its contribution to the burden of liver disease. We estimated the global prevalence of... • HDV infection is common among HBsAg-positive people worldwide. • Among HBsAg-positive people, estimated HDV prevalence is 4.5% (95% CI 3.6–5.7). • HDV... |
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| SubjectTerms | Adult Carcinoma Carcinoma, Hepatocellular - virology Coinfection - complications Coinfection - epidemiology Epidemiology Female Genotype Hepatitis Antibodies - blood Hepatitis B Hepatitis B - complications Hepatitis B - epidemiology Hepatitis B - virology Hepatitis B Surface Antigens Hepatitis B virus - immunology Hepatitis D Hepatitis D - blood Hepatitis D - complications Hepatitis D - epidemiology Hepatitis D - virology Hepatitis delta virus Hepatitis Delta Virus - genetics Hepatitis Delta Virus - immunology Hepatocellular Homosexuality, Male Humans Immunoglobulin G - blood Liver cirrhosis Liver Cirrhosis - virology Liver Neoplasms - virology Male Meta-analysis Prevalence Renal Dialysis - adverse effects RNA, Viral - genetics Sex Workers Sexual and Gender Minorities Substance Abuse, Intravenous - complications |
| Title | The global prevalence of hepatitis D virus infection: Systematic review and meta-analysis |
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