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. 2010 Sep 15;202(6):845-52.
doi: 10.1086/655808.

Prevalence, correlates, and viral dynamics of hepatitis delta among injection drug users

Lauren M Kucirka  1 , Homayoon Farzadegan, Jordan J Feld, Shruti H Mehta, Mark Winters, Jeffrey S Glenn, Gregory D Kirk, Dorry L Segev, Kenrad E Nelson, Morgan Marks, Theo Heller, Elizabeth T Golub
Affiliations

Prevalence, correlates, and viral dynamics of hepatitis delta among injection drug users

Lauren M Kucirka et al. J Infect Dis. .

Abstract

Background: Most hepatitis delta virus (HDV) prevalence estimates from the United States are >10 years old, and HDV has shown significant temporal variation in other populations. HDV-hepatitis B virus (HBV) dual infection progresses rapidly, has more complications, and has a different treatment regimen than HBV infection alone. Accurate estimates of prevalence and risk factors are important to help clinicians decide who to screen.

Methods: Injection drug users in Baltimore, Maryland, who were positive for HBV serologic markers were tested for hepatitis delta antibody (HDAb) at 2 time periods: 1988-1989 (194 participants) and 2005-2006 (258 participants). Those who were HDAb positive in 2005-2006, plus a random sample of HDAb negative, HBV-positive participants were tested for HDV RNA, HBV DNA, and HCV RNA. Characteristics associated with HDV exposure and viremia were identified.

Results: HDV prevalence declined from 15% in 1988-1989 to 11% in 2005-2006. Among those with chronic HBV infection, prevalence increased from 29% (14 of 48 participants) to 50% (19 of 38 participants) (P=.05). Visiting a "shooting gallery" (a location where people gather to inject illegal drugs) was a strong correlate of HDAb positivity (relative risk, 3.08; P=.01). Eight (32%) of those who were HDAb positive had HDV viremia. Viremic participants had elevated liver enzyme levels and more emergency room visits.

Conclusions: The temporal increase in HDV prevalence among those with chronic HBV infection is troubling; understanding this change should be a priority to prevent the burden from increasing.

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Conflict of interest statement

Conflicts of Interest: No authors have any conflicts of interest to report

Figures

Figure 1
Figure 1
Number of patients in eligible, sampled, and tested in each HBV serologic category, 1988-1989 cohort and 2005-2006 cohort. HBsAg = hepatitis B surface antigen sAb = hepatitis B surface antibody cAb = hepatitis B core antibody
See this image and copyright information in PMC

Comment in

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