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The changing scenario of hepatitis D
J Hepatol. 2021 Jan 20;S0168-8278(21)00023-4. doi: 10.1016/j.jhep.2021.01.014.Online ahead of print.
Mario Rizzetto1, Saeed Hamid2, Franco Negro3
1Department of Medical Sciences, University of Turin, Turin, Italy. Electronic address: firstname.lastname@example.org.
2Department of Medicine, The Aga Khan University, Karachi, Pakistan.
3Divisions of Gastroenterology and Hepatology and of; Clinical Pathology, Geneva University Hospitals, Geneva, Switzerland.
The global scenario of hepatitis D is changing with the widespread implementation of vaccination against hepatitis B. In high-income countries that achieved optimal control of HBV, the epidemiology of hepatitis D is dual, consisting of an ageing cohort of domestic patients with advanced liver fibrosis who represent the end stage of the natural history of HDV, and of a younger generation of immigrants from endemic countries who account for the majority of new infections. Similar to the features in Europe in the 1980s, in endemic countries the distinctive clinical characteristic of chronic hepatitis D is the accelerated progression to cirrhosis and hepatocellular carcinoma. Despite some recent progress, the therapeutic management of HDV remains unsatisfactory, as most patients are not cured of HDV with currently available medicines. This review article describes the current epidemiology and clinical features of chronic hepatitis D, based on the international literature of the last ten years.