Molecular epidemiology and clinical characteristics of hepatitis D virus infection in Canada.

Autor:	Osiowy C; National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada.; University of Manitoba, Winnipeg, MB, Canada., Swidinsky K; National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada., Haylock-Jacobs S; University of Calgary, Calgary, AB, Canada., Sadler MD; University of Calgary, Calgary, AB, Canada., Fung S; University of Toronto, Toronto, ON, Canada., Wong D; University of Toronto, Toronto, ON, Canada., Minuk GY; University of Manitoba, Winnipeg, MB, Canada., Doucette KE; University of Alberta, Edmonton, AB, Canada., Wong P; McGill University, Montreal, QC, Canada., Tam E; LAIR Centre, Vancouver, BC, Canada., Cooper C; University of Ottawa, Ottawa, ON, Canada., Ramji A; University of British Columbia, Vancouver, BC, Canada., Ma M; University of Alberta, Edmonton, AB, Canada., Nudo C; Hôpital de la Cité-de-la-Santé, Laval, QC, Canada., Tsoi K; McMaster University, Hamilton, ON, Canada., Coffin CS; University of Calgary, Calgary, AB, Canada.
Jazyk:	angličtina
Zdroj:	JHEP reports : innovation in hepatology [JHEP Rep] 2022 Feb 22; Vol. 4 (5), pp. 100461. Date of Electronic Publication: 2022 Feb 22 (Print Publication: 2022).
DOI:	10.1016/j.jhepr.2022.100461
Abstrakt:	Background & Aims: HDV affects 4.5-13% of chronic hepatitis B (CHB) patients globally, yet the prevalence of HDV infection in Canada is unknown. To investigate the prevalence, genotype, demographics, and clinical characteristics of HDV in Canada, we conducted a retrospective analysis of (1) HDV antibody and RNA positivity among referred specimens, and (2) a cross-sectional subset study of 135 HDV seropositive +/-RNA (HDV+) patients compared with 5,132 HBV mono-infected patients in the Canadian HBV Network. Methods: Anti-HDV IgG-positive specimens collected between 2012 and 2019 were RNA tested and the genotype determined. Patients enrolled in the Canadian HBV Network were >18 years of age and HBsAg-positive. Clinical data collected included risk factors, demographics, comorbidities, treatment, fibrosis assessment, and hepatic complications. Results: Of the referred patients, 338/7,080 (4.8%, 95% CI 4.3-5.3) were HDV seropositive, with 219/338 RNA-positive (64.8%, 95% CI 59.6-69.7). The HDV+ cohort were more likely to be born in Canada, to be White or Black/African/Caribbean than Asian, and reporting high-risk behaviours, compared with HBV mono-infected patients. Cirrhosis, complications of end-stage liver disease, and liver transplantation were significantly more frequent in the HDV+ cohort. HDV viraemia was significantly associated with elevated liver transaminases and cirrhosis. Five HDV genotypes were observed among referred patients but no association between genotype and clinical outcome was detected within the HDV+ cohort. Conclusions: Nearly 5% of the Canadian HBV referral population is HDV seropositive. HDV infection is highly associated with risk behaviours and both domestic and foreign-born patients with CHB. HDV was significantly associated with progressive liver disease highlighting the need for increased screening and surveillance of HDV in Canada. Lay Summary: Evidence of HDV infection was observed in approximately 5% of Canadians who were infected with HBV referred to medical specialists. HDV-positive patients were more likely to be male, born in Canada, or White or Black/African/Caribbean compared to Asian, and to have reported high-risk activities such as injection or intranasal drug use or high-risk sexual contact compared with patients infected with only HBV. Patients infected with HDV were also more likely to suffer severe liver disease, including liver cancer, compared with HBV mono-infected patients. Competing Interests: CSC within past 36 months: Grant or contract from Gilead Sciences, Janssen Pharmaceuticals, GSK; Consulting fees from Janssen Pharmaceuticals; Payment or honoraria from Gilead Sciences (all made to the University of Calgary). The other authors declare no conflicts of interest that pertain to this work. Please refer to the accompanying ICMJE disclosure forms for further details. (Crown Copyright © 2022 Published by Elsevier B.V. on behalf of European Association for the Study of the Liver (EASL).)
Databáze:	MEDLINE
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