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Abstract Details
Association between hepatitis delta virus with liver morbidity and mortality: A systematic literature review and meta-analysis
Hepatology. 2023 Oct 23. doi: 10.1097/HEP.0000000000000642. Online ahead of print.
2Division of Gastroenterology and Hepatology, Veterans Affairs Palo Alto Healthcare System, Stanford University School of Medicine, Palo Alto, California.
3Department of Business Economics, Health and Social Care; University of Applied Sciences and Arts of Southern Switzerland.
4Gilead Sciences Inc., Foster City, CA, USA.
5Maple Health Group, LLC, New York, NY, USA.
6Barts Liver Centre, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
Abstract
Background aims: Studies have suggested that patients with chronic hepatitis B (CHB), either co-, or super infected, have more aggressive liver disease progression than those with the hepatitis delta virus (HDV). This systematic literature review and meta-analysis examined whether HDV RNA status is associated with increased risk of advanced liver disease events (ALDEs), in patients who are HBsAg and HDV antibody positive.
Approach results: A total of 12 publications were included. Relative rates of progression to ALDE for HDV RNA+/detectable versus HDV RNA-/undetectable were extracted for analysis. Reported odds (OR) and hazard ratios (HRs) with 95% confidence intervals (CI) were pooled using the Hartung-Knapp-Sidik-Jonkman method for random-effects models. Presence of HDV RNA+ was associated with an increased risk of any ALDE (random effect [95% CI]: risk ratio (RR): 1.48 [0.93, 2.33]; HR: 2.62 [1.55, 4.44]). When compared to HDV RNA- patients, HDV RNA+ was associated with a significantly higher risk of progressing to compensated cirrhosis (RR 1.74 [1.24, 2.45]), decompensated cirrhosis (HR 3.82 [1.60, 9.10]), hepatocellular carcinoma (HR 2.97 [1.87, 4.70]), liver transplantation (HR 7.07 [1.61, 30.99]), and liver-related mortality (HR 3.78 [2.18, 6.56]).
Conclusion: Patients with HDV RNA+ status have a significantly greater risk of liver disease progression than patients who are HDV RNA-. These findings highlight the need for improved HDV screening and linkage to treatment to reduce the risk of liver-related morbidity and mortality.
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