Changing hepatitis D virus epidemiology in a hepatitis B virus endemic area with a national vaccination program

The emergence of hepatitis D virus (HDV) infection in the era of widespread HBV vaccination has not been described before. We aimed to investigate the changing epidemiology of HDV infection among high‐ and low‐risk populations after an outbreak of human immunodeficiency virus (HIV) infection among i...

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Published inHepatology (Baltimore, Md.) Vol. 61; no. 6; pp. 1870 - 1879
Main Authors Lin, Hsi‐Hsun, Lee, Susan Shin‐Jung, Yu, Ming‐Lung, Chang, Ting‐Tsung, Su, Chien‐Wei, Hu, Bor‐Shen, Chen, Yaw‐Sen, Huang, Chun‐Kai, Lai, Chung‐Hsu, Lin, Jiun‐Nong, Wu, Jaw‐Ching
Format Journal Article
LanguageEnglish
Published United States Wolters Kluwer Health, Inc 01.06.2015
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Abstract The emergence of hepatitis D virus (HDV) infection in the era of widespread HBV vaccination has not been described before. We aimed to investigate the changing epidemiology of HDV infection among high‐ and low‐risk populations after an outbreak of human immunodeficiency virus (HIV) infection among injection drug users (IDUs) in Taiwan. A prospective, multicenter, cohort study of 2,562 hepatitis B surface antigen (HBsAg)‐positive individuals was conducted to determine the prevalence, genotype, and risk factors of HDV infection from 2001 through 2012. The prevalence rates of HDV infection were 74.9%, 43.9%, 11.4%, 11.1%, and 4.4% among HIV‐infected IDUs, HIV‐uninfected IDUs, HIV‐infected men who have sex with men, HIV‐infected heterosexuals, and the general population of HBsAg‐positive subjects, respectively. A significant increase in the trend of HDV prevalence from 38.5% to 89.8% was observed in HIV‐infected IDUs (odds ratio = 3.06; 95% confidence interval: 1.68‐5.56; P = 0.0002). In multivariate analysis, injection drug use, hepatitis C virus infection, HIV infection, serum HBsAg level ≧250 IU/mL, duration of drug use, and older age were significant factors associated with HDV infection. HDV genotype IV (72.2%) was the prevalent genotype circulating among IDUs, whereas genotype II was predominant in the non‐IDU populations (73.3%). In the HIV cohort born after 1987 who were HBsAg negative, over half (52.9%) had antibody to hepatitis B surface antigen antibody levels of <10 mIU/mL and there was a significantly higher HBsAg seroprevalence in the HIV cohort, compared to the control group (8.1% vs. 0.0%; P = 0.02). Conclusion: In the era of HBV vaccination, IDUs and HIV‐infected individuals have emerged as high‐risk groups and a reservoir for HDV infection. Effective strategies are needed to curb the reemerging epidemic of HDV infection in these high‐risk groups. (Hepatology 2015;61:1870–1879)
AbstractList The emergence of hepatitis D virus (HDV) infection in the era of widespread HBV vaccination has not been described before. We aimed to investigate the changing epidemiology of HDV infection among high- and low-risk populations after an outbreak of human immunodeficiency virus (HIV) infection among injection drug users (IDUs) in Taiwan. A prospective, multicenter, cohort study of 2,562 hepatitis B surface antigen (HBsAg)-positive individuals was conducted to determine the prevalence, genotype, and risk factors of HDV infection from 2001 through 2012. The prevalence rates of HDV infection were 74.9%, 43.9%, 11.4%, 11.1%, and 4.4% among HIV-infected IDUs, HIV-uninfected IDUs, HIV-infected men who have sex with men, HIV-infected heterosexuals, and the general population of HBsAg-positive subjects, respectively. A significant increase in the trend of HDV prevalence from 38.5% to 89.8% was observed in HIV-infected IDUs (odds ratio = 3.06; 95% confidence interval: 1.68-5.56; P = 0.0002). In multivariate analysis, injection drug use, hepatitis C virus infection, HIV infection, serum HBsAg level ≧250 IU/mL, duration of drug use, and older age were significant factors associated with HDV infection. HDV genotype IV (72.2%) was the prevalent genotype circulating among IDUs, whereas genotype II was predominant in the non-IDU populations (73.3%). In the HIV cohort born after 1987 who were HBsAg negative, over half (52.9%) had antibody to hepatitis B surface antigen antibody levels of <10 mIU/mL and there was a significantly higher HBsAg seroprevalence in the HIV cohort, compared to the control group (8.1% vs. 0.0%; P = 0.02).UNLABELLEDThe emergence of hepatitis D virus (HDV) infection in the era of widespread HBV vaccination has not been described before. We aimed to investigate the changing epidemiology of HDV infection among high- and low-risk populations after an outbreak of human immunodeficiency virus (HIV) infection among injection drug users (IDUs) in Taiwan. A prospective, multicenter, cohort study of 2,562 hepatitis B surface antigen (HBsAg)-positive individuals was conducted to determine the prevalence, genotype, and risk factors of HDV infection from 2001 through 2012. The prevalence rates of HDV infection were 74.9%, 43.9%, 11.4%, 11.1%, and 4.4% among HIV-infected IDUs, HIV-uninfected IDUs, HIV-infected men who have sex with men, HIV-infected heterosexuals, and the general population of HBsAg-positive subjects, respectively. A significant increase in the trend of HDV prevalence from 38.5% to 89.8% was observed in HIV-infected IDUs (odds ratio = 3.06; 95% confidence interval: 1.68-5.56; P = 0.0002). In multivariate analysis, injection drug use, hepatitis C virus infection, HIV infection, serum HBsAg level ≧250 IU/mL, duration of drug use, and older age were significant factors associated with HDV infection. HDV genotype IV (72.2%) was the prevalent genotype circulating among IDUs, whereas genotype II was predominant in the non-IDU populations (73.3%). In the HIV cohort born after 1987 who were HBsAg negative, over half (52.9%) had antibody to hepatitis B surface antigen antibody levels of <10 mIU/mL and there was a significantly higher HBsAg seroprevalence in the HIV cohort, compared to the control group (8.1% vs. 0.0%; P = 0.02).In the era of HBV vaccination, IDUs and HIV-infected individuals have emerged as high-risk groups and a reservoir for HDV infection. Effective strategies are needed to curb the reemerging epidemic of HDV infection in these high-risk groups.CONCLUSIONIn the era of HBV vaccination, IDUs and HIV-infected individuals have emerged as high-risk groups and a reservoir for HDV infection. Effective strategies are needed to curb the reemerging epidemic of HDV infection in these high-risk groups.
The emergence of hepatitis D virus (HDV) infection in the era of widespread HBV vaccination has not been described before. We aimed to investigate the changing epidemiology of HDV infection among high‐ and low‐risk populations after an outbreak of human immunodeficiency virus (HIV) infection among injection drug users (IDUs) in Taiwan. A prospective, multicenter, cohort study of 2,562 hepatitis B surface antigen (HBsAg)‐positive individuals was conducted to determine the prevalence, genotype, and risk factors of HDV infection from 2001 through 2012. The prevalence rates of HDV infection were 74.9%, 43.9%, 11.4%, 11.1%, and 4.4% among HIV‐infected IDUs, HIV‐uninfected IDUs, HIV‐infected men who have sex with men, HIV‐infected heterosexuals, and the general population of HBsAg‐positive subjects, respectively. A significant increase in the trend of HDV prevalence from 38.5% to 89.8% was observed in HIV‐infected IDUs (odds ratio = 3.06; 95% confidence interval: 1.68‐5.56; P = 0.0002). In multivariate analysis, injection drug use, hepatitis C virus infection, HIV infection, serum HBsAg level ≧250 IU/mL, duration of drug use, and older age were significant factors associated with HDV infection. HDV genotype IV (72.2%) was the prevalent genotype circulating among IDUs, whereas genotype II was predominant in the non‐IDU populations (73.3%). In the HIV cohort born after 1987 who were HBsAg negative, over half (52.9%) had antibody to hepatitis B surface antigen antibody levels of <10 mIU/mL and there was a significantly higher HBsAg seroprevalence in the HIV cohort, compared to the control group (8.1% vs. 0.0%; P = 0.02). Conclusion: In the era of HBV vaccination, IDUs and HIV‐infected individuals have emerged as high‐risk groups and a reservoir for HDV infection. Effective strategies are needed to curb the reemerging epidemic of HDV infection in these high‐risk groups. (Hepatology 2015;61:1870–1879)
The emergence of hepatitis D virus (HDV) infection in the era of widespread HBV vaccination has not been described before. We aimed to investigate the changing epidemiology of HDV infection among high- and low-risk populations after an outbreak of human immunodeficiency virus (HIV) infection among injection drug users (IDUs) in Taiwan. A prospective, multicenter, cohort study of 2,562 hepatitis B surface antigen (HBsAg)-positive individuals was conducted to determine the prevalence, genotype, and risk factors of HDV infection from 2001 through 2012. The prevalence rates of HDV infection were 74.9%, 43.9%, 11.4%, 11.1%, and 4.4% among HIV-infected IDUs, HIV-uninfected IDUs, HIV-infected men who have sex with men, HIV-infected heterosexuals, and the general population of HBsAg-positive subjects, respectively. A significant increase in the trend of HDV prevalence from 38.5% to 89.8% was observed in HIV-infected IDUs (odds ratio = 3.06; 95% confidence interval: 1.68-5.56; P = 0.0002). In multivariate analysis, injection drug use, hepatitis C virus infection, HIV infection, serum HBsAg level ≧250 IU/mL, duration of drug use, and older age were significant factors associated with HDV infection. HDV genotype IV (72.2%) was the prevalent genotype circulating among IDUs, whereas genotype II was predominant in the non-IDU populations (73.3%). In the HIV cohort born after 1987 who were HBsAg negative, over half (52.9%) had antibody to hepatitis B surface antigen antibody levels of <10 mIU/mL and there was a significantly higher HBsAg seroprevalence in the HIV cohort, compared to the control group (8.1% vs. 0.0%; P = 0.02). In the era of HBV vaccination, IDUs and HIV-infected individuals have emerged as high-risk groups and a reservoir for HDV infection. Effective strategies are needed to curb the reemerging epidemic of HDV infection in these high-risk groups.
The emergence of hepatitis D virus (HDV) infection in the era of widespread HBV vaccination has not been described before. We aimed to investigate the changing epidemiology of HDV infection among high- and low-risk populations after an outbreak of human immunodeficiency virus (HIV) infection among injection drug users (IDUs) in Taiwan. A prospective, multicenter, cohort study of 2,562 hepatitis B surface antigen (HBsAg)-positive individuals was conducted to determine the prevalence, genotype, and risk factors of HDV infection from 2001 through 2012. The prevalence rates of HDV infection were 74.9%, 43.9%, 11.4%, 11.1%, and 4.4% among HIV-infected IDUs, HIV-uninfected IDUs, HIV-infected men who have sex with men, HIV-infected heterosexuals, and the general population of HBsAg-positive subjects, respectively. A significant increase in the trend of HDV prevalence from 38.5% to 89.8% was observed in HIV-infected IDUs (odds ratio=3.06; 95% confidence interval: 1.68-5.56; P=0.0002). In multivariate analysis, injection drug use, hepatitis C virus infection, HIV infection, serum HBsAg level 250 IU/mL, duration of drug use, and older age were significant factors associated with HDV infection. HDV genotype IV (72.2%) was the prevalent genotype circulating among IDUs, whereas genotype II was predominant in the non-IDU populations (73.3%). In the HIV cohort born after 1987 who were HBsAg negative, over half (52.9%) had antibody to hepatitis B surface antigen antibody levels of <10 mIU/mL and there was a significantly higher HBsAg seroprevalence in the HIV cohort, compared to the control group (8.1% vs. 0.0%; P=0.02). Conclusion: In the era of HBV vaccination, IDUs and HIV-infected individuals have emerged as high-risk groups and a reservoir for HDV infection. Effective strategies are needed to curb the reemerging epidemic of HDV infection in these high-risk groups. (Hepatology 2015;61:1870-1879)
The emergence of hepatitis D virus (HDV) infection in the era of widespread HBV vaccination has not been described before. We aimed to investigate the changing epidemiology of HDV infection among high‐ and low‐risk populations after an outbreak of human immunodeficiency virus (HIV) infection among injection drug users (IDUs) in Taiwan. A prospective, multicenter, cohort study of 2,562 hepatitis B surface antigen (HBsAg)‐positive individuals was conducted to determine the prevalence, genotype, and risk factors of HDV infection from 2001 through 2012. The prevalence rates of HDV infection were 74.9%, 43.9%, 11.4%, 11.1%, and 4.4% among HIV‐infected IDUs, HIV‐uninfected IDUs, HIV‐infected men who have sex with men, HIV‐infected heterosexuals, and the general population of HBsAg‐positive subjects, respectively. A significant increase in the trend of HDV prevalence from 38.5% to 89.8% was observed in HIV‐infected IDUs (odds ratio = 3.06; 95% confidence interval: 1.68‐5.56; P  = 0.0002). In multivariate analysis, injection drug use, hepatitis C virus infection, HIV infection, serum HBsAg level ≧250 IU/mL, duration of drug use, and older age were significant factors associated with HDV infection. HDV genotype IV (72.2%) was the prevalent genotype circulating among IDUs, whereas genotype II was predominant in the non‐IDU populations (73.3%). In the HIV cohort born after 1987 who were HBsAg negative, over half (52.9%) had antibody to hepatitis B surface antigen antibody levels of <10 mIU/mL and there was a significantly higher HBsAg seroprevalence in the HIV cohort, compared to the control group (8.1% vs. 0.0%; P  = 0.02). Conclusion : In the era of HBV vaccination, IDUs and HIV‐infected individuals have emerged as high‐risk groups and a reservoir for HDV infection. Effective strategies are needed to curb the reemerging epidemic of HDV infection in these high‐risk groups. (H epatology 2015;61:1870–1879)
Author Chen, Yaw‐Sen
Lin, Jiun‐Nong
Lai, Chung‐Hsu
Chang, Ting‐Tsung
Su, Chien‐Wei
Hu, Bor‐Shen
Lee, Susan Shin‐Jung
Lin, Hsi‐Hsun
Huang, Chun‐Kai
Wu, Jaw‐Ching
Yu, Ming‐Lung
Author_xml – sequence: 1
  givenname: Hsi‐Hsun
  surname: Lin
  fullname: Lin, Hsi‐Hsun
  organization: E‐Da Hospital/I‐Shou University
– sequence: 2
  givenname: Susan Shin‐Jung
  surname: Lee
  fullname: Lee, Susan Shin‐Jung
  organization: Kaohsiung Veterans General Hospital
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  givenname: Ming‐Lung
  surname: Yu
  fullname: Yu, Ming‐Lung
  organization: Kaohsiung Medical University Hospital, Kaohsiung Medical University
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  givenname: Ting‐Tsung
  surname: Chang
  fullname: Chang, Ting‐Tsung
  organization: Medical College of National Cheng Kung University
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  givenname: Chien‐Wei
  surname: Su
  fullname: Su, Chien‐Wei
  organization: Taipei Veterans General Hospital
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  givenname: Bor‐Shen
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  fullname: Hu, Bor‐Shen
  organization: Taipei City Hospital, Taipei City Government
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  surname: Chen
  fullname: Chen, Yaw‐Sen
  organization: E‐Da Hospital/I‐Shou University
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  surname: Huang
  fullname: Huang, Chun‐Kai
  organization: E‐Da Hospital/I‐Shou University
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  surname: Lai
  fullname: Lai, Chung‐Hsu
  organization: E‐Da Hospital/I‐Shou University
– sequence: 10
  givenname: Jiun‐Nong
  surname: Lin
  fullname: Lin, Jiun‐Nong
  organization: E‐Da Hospital/I‐Shou University
– sequence: 11
  givenname: Jaw‐Ching
  surname: Wu
  fullname: Wu, Jaw‐Ching
  organization: Taipei Veterans General Hospital
BackLink https://www.ncbi.nlm.nih.gov/pubmed/25677884$$D View this record in MEDLINE/PubMed
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Notes This study was supported by grants from Taipei Veterans General Hospital (V101C‐087, V102C‐127, and V103C‐026), partially by a grant (103AC‐T402; Aim for the Top University Plan) from the National Yang‐Ming University, Ministry of Education, and E‐Da Hospital (EDAHP97001, EDAHP98001, and EDAHI102002). Both hospitals were not involved in any part of the data collection, analysis, and manuscript writing.
Potential conflict of interest: Nothing to report.
These authors made an equal contribution.
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Snippet The emergence of hepatitis D virus (HDV) infection in the era of widespread HBV vaccination has not been described before. We aimed to investigate the changing...
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StartPage 1870
SubjectTerms Adult
Aged
Antigens
Coinfection
Confidence intervals
Drug use
Drug Users - statistics & numerical data
Endemic Diseases - prevention & control
Epidemiology
Female
Genotype & phenotype
Hepatitis
Hepatitis B
Hepatitis B - epidemiology
Hepatitis B - prevention & control
Hepatitis B Vaccines
Hepatitis D - epidemiology
Hepatitis delta virus
Hepatitis Delta Virus - genetics
Hepatology
HIV
HIV Infections - virology
Human immunodeficiency virus
Humans
Incidence
Infections
Longitudinal Studies
Male
Mass Vaccination
Middle Aged
Multivariate Analysis
Prevalence
Prospective Studies
Risk Factors
Taiwan - epidemiology
Viremia - epidemiology
Title Changing hepatitis D virus epidemiology in a hepatitis B virus endemic area with a national vaccination program
URI https://onlinelibrary.wiley.com/doi/abs/10.1002%2Fhep.27742
https://www.ncbi.nlm.nih.gov/pubmed/25677884
https://www.proquest.com/docview/1681927992
https://www.proquest.com/docview/1682888852
Volume 61
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