Prevalence and burden of hepatitis D virus infection in the global population: a systematic review and meta-analysis
- PMID: 30228220
- DOI: 10.1136/gutjnl-2018-316601
Prevalence and burden of hepatitis D virus infection in the global population: a systematic review and meta-analysis
Abstract
Objective: Hepatitis D virus (HDV) is a defective virus that completes its life cycle only with hepatitis B virus (HBV). The HBV with HDV super-infection has been considered as one of the most severe forms of the chronic viral hepatitis. However, there is a scarcity of data on the global burden of HDV infection.
Design: We searched PubMed, Embase, Cochrane Library and China Knowledge Resource Integrated databases from 1 January 1977 to 31 December 2016. We included studies with a minimum sample size of 50 patients. Our study analysed data from a total of 40 million individuals to estimate the prevalence of HDV by using Der-Simonian Laird random-effects model. The data were further categorised according to risk factors.
Results: From a total of 2717 initially identified studies, only 182 articles from 61 countries and regions met the final inclusion criteria. The overall prevalence of HDV was 0.98% (95% CI 0.61 to 1.42). In HBsAg-positive population, HDV pooled prevalence was 14.57% (95% CI 12.93 to 16.27): Seroprevalence was 10.58% (95% CI 9.14 to 12.11) in mixed population without risk factors of intravenous drug use (IVDU) and high-risk sexual behaviour (HRSB). It was 37.57% (95% CI 29.30 to 46.20) in the IVDU population and 17.01% (95% CI 10.69 to 24.34) in HRSB population.
Conclusion: We found that approximately 10.58% HBsAg carriers (without IVDU and HRSB) were coinfected with HDV, which is twofold of what has been estimated before. We also noted a substantially higher HDV prevalence in the IVDU and HRSB population. Our study highlights the need for increased focus on the routine HDV screening and rigorous implementation of HBV vaccine programme.
Keywords: hepatitis B; hepatitis D; meta-analysis.
© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.
Conflict of interest statement
Competing interests: None declared.
Comment in
-
Devil hepatitis D: an orphan disease or largely underdiagnosed?Gut. 2019 Mar;68(3):381-382. doi: 10.1136/gutjnl-2018-317403. Epub 2018 Oct 27. Gut. 2019. PMID: 30368454 No abstract available.
-
Hepatitis D prevalence: problems with extrapolation to global population estimates.Gut. 2020 Feb;69(2):396-397. doi: 10.1136/gutjnl-2018-317874. Epub 2018 Dec 19. Gut. 2020. PMID: 30567743 No abstract available.
-
Hepatitis D: not a rare disease anymore: global update for 2017-2018.Gut. 2020 Apr;69(4):786-788. doi: 10.1136/gutjnl-2019-318691. Epub 2019 Apr 9. Gut. 2020. PMID: 30967414 No abstract available.
-
Differences in delta virus hepatitis diagnosis methods and its effect on the hepatitis D prevalence.Gut. 2020 Oct;69(10):1893. doi: 10.1136/gutjnl-2019-320159. Epub 2019 Nov 12. Gut. 2020. PMID: 31719130 No abstract available.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical
Miscellaneous