Hepatitis Delta Virus Reporting Requirements in the United States and Territories: A Systematic Review

Abstract

Hepatitis D virus (HDV) is a rare coinfection with hepatitis B virus. Currently, HDV is not a nationally notifiable disease in the United States. Only 55% of states and territories require HDV reporting, and most lack defined case definitions. Standardization of reporting requirements is crucial for monitoring HDV epidemiology.

Keywords: HDV; hepD; hepatitis D virus; hepatitis Delta virus; kolmioviridae.

Figure 1.

Hepatitis D virus (HDV) and hepatitis B virus (HBV) structures and HDV testing guidelines. A, HDV is a satellite RNA that requires a helper virus for packaging and transmission. The HDV ribonucleoprotein complex, composed of the HDV RNA genome and 2 viral antigens (S-HDAg and L-HDAg), is packaged into an envelope membrane containing HBV surface antigens (HBSAg). HDV then utilizes the same cell surface receptor as HBV, the sodium taurocholate co-transporting polypeptide (NTCP), and shares a tissue tropism profile similar to that of HBV. B, Testing for acute HDV coinfections is commonly performed using anti-HDAg IgM to detect recent HDV infections and anti-HDAg immunoglobulin G (IgG) or total anti-HDAg antibodies to detect acute HDV infections at later stages of infection. Patients who test positive for HDV-targeted antibodies should be tested for HDV RNA. C, Testing for chronic HDV coinfections focuses on the detection of anti-HDAg IgG or total anti-HDAg antibodies. Similar to acute HDV coinfection testing, patients who test positive for HDV-targeted antibodies may further be tested for HDV RNA and/or HDAg. Created with BioRender.com.

Figure 2.

Map of hepatitis Delta virus reporting requirements for United States and territories. The map details states and territories that require reporting of hepatitis D virus (HDV) diagnoses. Thirty-one of the 56 United States and territories (55%) required the reporting of HDV-positive laboratory tests to local health departments. Currently, 45% of the states and territories do not categorize HDV as a reportable disease. Of the 31 states and territories requiring reporting of HDV, 19% required reporting of positive anti-HDV antibody laboratory results, 23% required reporting of positive anti-HDV antibodies and/or HDV RNA laboratory results, and 58% reported accepting any HDV-positive laboratory results. Map were produced using mapcharts.net.