Prevalence and determinants of hepatitis delta virus infection among HIV/hepatitis B-coinfected adults in care in the United States

• Published in: Journal of viral hepatitis Vol. 30; no. 11; pp. 879 - 888
• Main Authors: Ferrante, Nicole D, Kallan, Michael J, Sukkestad, Sophia, Kodani, Maja, Kitahata, Mari M, Cachay, Edward R, Bhattacharya, Debika, Heath, Sonya, Napravnik, Sonia, Moore, Richard D, Yendewa, George, Mayer, Kenneth H, Reddy, K Rajender, Hayden, Tonya, Kamili, Saleem, Martin, Jeffrey N, Kim, H Nina, Lo Re, 3rd, Vincent
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.11.2023
• Subjects: Acquired immune deficiency syndrome; Adult; AIDS; Antibodies; Coinfection; Cross-Sectional Studies; Female; Generalized linear models; Hepatitis Antibodies; Hepatitis B; Hepatitis B - complications; Hepatitis B - epidemiology; Hepatitis B virus - genetics; Hepatitis delta virus; Hepatitis Delta Virus - genetics; HIV; HIV Infections - complications; HIV Infections - epidemiology; Human immunodeficiency virus; Humans; Immunoglobulin G; Infections; Male; Prevalence; Ribonucleic acid; RNA; Sexual behavior; United States - epidemiology; Viruses; United States; United States > US; epidemiology; prevalence; HIV HBV and HDV coinfection; hepatitis B virus; hepatitis delta virus
• ISSN: 1352-0504; 1365-2893; 1365-2893
• DOI: 10.1111/jvh.13874

Hepatitis delta virus (HDV) infection increases the risk of liver complications compared to hepatitis B virus (HBV) alone, particularly among persons with human immunodeficiency virus (HIV). However, no studies have evaluated the prevalence or determinants of HDV infection among people with HIV/HBV in the US. We performed a cross-sectional study among adults with HIV/HBV coinfection receiving care at eight sites within the Center for AIDS Research Network of Integrated Clinical Systems (CNICS) between 1996 and 2019. Among patients with available serum/plasma specimens, we selected the first specimen on or after their initial HBV qualifying test. All samples were tested for HDV IgG antibody and HDV RNA. Multivariable log-binomial generalized linear models were used to estimate prevalence ratios (PRs) with 95% CIs of HDV IgG antibody-positivity associated with determinants of interest (age, injection drug use [IDU], high-risk sexual behaviour). Among 597 adults with HIV/HBV coinfection in CNICS and available serum/plasma samples (median age, 43 years; 89.9% male; 52.8% Black; 42.4% White), 24/597 (4.0%; 95% CI, 2.4%-5.6%) were HDV IgG antibody-positive, and 10/596 (1.7%; 95% CI, 0.6%-2.7%) had detectable HDV RNA. In multivariable analysis, IDU was associated with exposure to HDV infection (adjusted PR = 2.50; 95% CI, 1.09-5.74). In conclusion, among a sample of adults with HIV/HBV coinfection in care in the US, 4.0% were HDV IgG antibody-positive, among whom 41.7% had detectable HDV RNA. History of IDU was associated with exposure to HDV infection. These findings emphasize the importance of HDV testing among persons with HIV/HBV coinfection, especially those with a history of IDU.