Hepatitis Delta Virus Testing and Prevalence Among Chronic Hepatitis B Patients Across Three U.S. Safety-net Health Systems.

IF 11.6 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Clinical Gastroenterology and Hepatology Pub Date : 2024-10-24 DOI:10.1016/j.cgh.2024.09.025

Robert J Wong, Mamta K Jain, Bolin Niu, Yi Zhang, George Therapondos, Mae Thamer

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引用次数: 0

Abstract

Background & aims: Despite a high prevalence of risk factors associated with hepatitis delta virus (HDV) infection among safety-net populations, data evaluating HDV testing and prevalence are limited. We aim to evaluate HDV testing practices and HDV prevalence among an ethnically diverse, multi-center cohort of safety-net patients with chronic hepatitis B (CHB).

Methods: We retrospectively evaluated 13,218 patients with CHB (54.2% male, 57.9% non-White minorities, 12.5% human immunodeficiency virus, and 23.0% hepatitis C virus) across 3 United States safety-net health systems from 2010 to 2022 to evaluate proportion tested for HDV and proportion positive among those tested. Adjusted multivariate logistic regression models evaluated for predictors of HDV testing and predictors of anti-HDV positive.

Results: Anti-HDV testing was performed in 6.1% overall and in 4.9% that met American Association for the Study of Liver Diseases criteria for HDV testing. Greater odds of testing were observed in men vs women (odds ratio [OR], 1.49; 95% confidence interval [CI], 1.27-1.75), Asian individuals vs White individuals (OR, 2.18; 95% CI, 1.74-2.72), Black/African American individuals vs White individuals (OR, 1.29; 95% CI, 1.07-1.56), and patients with Medicare or Medicaid. Among patients with CHB tested for HDV, 15.7% were positive (22.9% among those meeting American Association for the Study of Liver Diseases HDV testing criteria). Only 2 patients (1.6%) had follow-up HDV RNA testing. Greater proportion of anti-HDV positive was observed in patients with baseline cirrhosis (47.4% vs 13.3%; P < .001), and patients with Medicare or Medicaid vs those with commercial insurance.

Conclusions: Among an ethnically diverse, multi-center safety-net cohort of patients with CHB, low rates of HDV testing were observed, even among those with high-risk HDV risk factors. Among those tested, 15.7% were positive, only 2 had follow up RNA testing. This highlights the need for greater awareness, education, and advocacy to improve HDV testing rates.

查看原文本刊更多论文

美国三个安全网医疗系统中慢性乙型肝炎患者的 Delta 病毒检测和流行率。

背景与目的：尽管在安全网人群中与乙型肝炎病毒（HDV）感染相关的风险因素流行率很高，但评估 HDV 检测和流行率的数据却很有限。我们旨在评估不同种族、多中心慢性乙型肝炎（CHB）安全网患者队列中的 HDV 检测方法和 HDV 感染率：我们回顾性评估了 2010-2022 年间美国三个安全网医疗系统中的 13,218 名慢性乙型肝炎患者（54.2% 为男性，57.9% 为非白人少数民族，12.5% 为 HIV 感染者，23.0% 为 HCV 感染者），以评估 HDV 检测比例以及检测结果呈阳性的患者比例。调整后的多变量逻辑回归模型评估了 HDV 检测的预测因素和抗 HDV 阳性的预测因素：6.1%的患者进行了抗HDV检测，4.9%的患者符合AASLD的HDV检测标准。男性与女性（OR 1.49，95%CI 1.27-1.75）、亚洲人与白人（OR 2.18，95%CI 1.74-2.72）、黑人/非洲裔美国人与白人（OR 1.29，95%CI 1.07-1.56）以及享受医疗保险或医疗补助的患者进行检测的几率更大。在接受 HDV 检测的慢性阻塞性肺病患者中，15.7% 呈阳性（在符合 AASLD HDV 检测标准的患者中为 22.9%）。只有 2 例（1.6%）患者进行了 HDV RNA 后续检测。基线肝硬化患者的抗 HDV 阳性比例更高（47.4% 对 13.3%，p 结论：在一个种族多元化、多中心安全网队列的慢性阻塞性肺病患者中，HDV检测率很低，即使是那些具有高危HDV风险因素的患者也是如此。在接受检测的患者中，15.7%呈阳性，只有2人进行了后续RNA检测。这凸显了加强意识、教育和宣传以提高 HDV 检测率的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Gastroenterology and Hepatology 医学-胃肠肝病学

CiteScore

16.90

自引率

4.80%

发文量

903

审稿时长

22 days

期刊介绍： Clinical Gastroenterology and Hepatology (CGH) is dedicated to offering readers a comprehensive exploration of themes in clinical gastroenterology and hepatology. Encompassing diagnostic, endoscopic, interventional, and therapeutic advances, the journal covers areas such as cancer, inflammatory diseases, functional gastrointestinal disorders, nutrition, absorption, and secretion. As a peer-reviewed publication, CGH features original articles and scholarly reviews, ensuring immediate relevance to the practice of gastroenterology and hepatology. Beyond peer-reviewed content, the journal includes invited key reviews and articles on endoscopy/practice-based technology, health-care policy, and practice management. Multimedia elements, including images, video abstracts, and podcasts, enhance the reader's experience. CGH remains actively engaged with its audience through updates and commentary shared via platforms such as Facebook and Twitter.