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J Clin Virol. 2015 May;66:33-7. doi: 10.1016/j.jcv.2015.02.011. Epub 2015 Feb 20.

Hepatitis delta virus testing, epidemiology and management: a multicentre cross-sectional study of patients in London.

Author information

1
University College London Hospitals NHS Foundation Trust, Department of Clinical Microbiology and Virology, 2nd Floor, 307 Euston Road, London NW1 3AD, UK. Electronic address: kate.elbouzidi@nhs.net.
2
Barts Health NHS Trust, Division of Infection, Pharmacy and Pathology Building, 80 Newark Street, London E1 2ES, UK.
3
University College London Hospitals NHS Foundation Trust, Department of Clinical Microbiology and Virology, 2nd Floor, 307 Euston Road, London NW1 3AD, UK.
4
Royal Free London NHS Foundation Trust, Department of Virology, Royal Free Hospital, Pond Street, London NW3 2QG, UK.
5
Barts Health NHS Trust, Department of Hepatology, The Royal London Hospital, Whitechapel Road, London E1 1BB, UK.
6
UCL Institute for Liver and Digestive Health, Royal Free Hospital, Pond Street, London NW3 2QG, UK.
7
UCL Research Department of Infection and Population Health Royal Free Campus, Rowland Hill Street, London NW3 2PF, UK.
8
Imperial College Healthcare NHS Trust, Hepatology Research Unit, St. Mary's Hospital, Praed Street, London W2 1NY, UK.
9
University College London Hospitals NHS Foundation Trust, Department of Clinical Microbiology and Virology, 2nd Floor, 307 Euston Road, London NW1 3AD, UK. Electronic address: e.nastouli@ucl.ac.uk.

Abstract

BACKGROUND:

Hepatitis delta virus (HDV) testing is recommended for all patients with hepatitis B virus (HBV) infection. HDV infection is associated with severe liver disease and interferon is the only available treatment.

OBJECTIVES:

To determine the rate of anti-HDV antibody testing in HBV patients; and to describe the epidemiology, clinical characteristics and management of HDV-infected patients at four hospitals in London.

STUDY DESIGN:

The anti-HDV testing rate was estimated by reviewing clinical and laboratory data. Cross-sectional data collection identified HDV-infected patients who had attended the study centres between 2005 and 2012.

RESULTS:

At a centre with clinic-led anti-HDV testing, 40% (67/168) of HBV patients were tested. Recently diagnosed HBV patients were more likely to be screened than those under long-term follow-up (62% vs 36%, P=0.01). At a centre with reflex laboratory testing, 99.4% (3543/3563) of first hepatitis B surface antigen positive samples were tested for anti-HDV. Across the four study centres there were 55 HDV-infected patients, of whom 50 (91%) had immigrated to the UK and 27 (49%) had evidence of cirrhosis. 31 patients received interferon therapy for HDV with an end of treatment virological response observed in 10 (32%).

CONCLUSIONS:

The anti-HDV testing rate was low in a centre with clinic-led testing, but could not be evaluated in all centres. The HDV-infected patients were of diverse ethnicity, with extensive histological evidence of liver disease and poor therapeutic responses. Future recommendations include reflex laboratory testing algorithms and a prospective cohort study to optimise the investigation and management of these patients.

KEYWORDS:

Epidemiology; HBV; HDV; Management; Testing

PMID:
25866333
DOI:
10.1016/j.jcv.2015.02.011
[Indexed for MEDLINE]
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