A holistic evaluation of patients with chronic Hepatitis D virus (HDV) infection enrolled in the Italian PITER-B and delta cohort

Int J Infect Dis. 2024 Sep:146:107115. doi: 10.1016/j.ijid.2024.107115. Epub 2024 May 26.

Abstract

Background and aims: We aimed to characterize the epidemiologic and comorbidities profiles of patients with chronic Hepatitis D (CHD) followed in clinical practice in Italy and explored their interferon (IFN) eligibility.

Methods: This was a cross-sectional study of the PITER cohort consisting of consecutive HBsAg-positive patients from 59 centers over the period 2019-2023. Multivariable analysis was performed by logistic regression model.

Results: Of 5492 HBsAg-positive enrolled patients, 4152 (75.6%) were screened for HDV, 422 (10.2%) were anti-HDV positive. Compared with HBsAg mono-infected, anti-HDV positive patients were more often younger, non-Italians, with a history of drug use, had elevated alanine transaminase (ALT), cirrhosis, or hepatocellular carcinoma (HCC). Compared with Italians, anti-HDV positive non-Italians were younger (42.2% age ≤ 40 years vs. 2.1%; P < 0.001), more often females (males 43.0% vs. 68.6%; P < 0.001) with less frequent cirrhosis and HCC. HDV-RNA was detected in 63.2% of anti-HDV-positive patients, who were more likely to have elevated ALT, cirrhosis, and HCC. Extrahepatic comorbidities were present in 47.4% of anti-HDV positive patients and could affect the eligibility of IFN-containing therapies in at least 53.0% of patients in care.

Conclusions: CHD affects young, foreign-born patients and older Italians, of whom two-thirds had cirrhosis or HCC. Comorbidities were frequent in both Italians and non-Italians and impacted eligibility for IFN.

Keywords: Cohort; Comorbidities; IFN treatment.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Antiviral Agents / therapeutic use
  • Carcinoma, Hepatocellular / epidemiology
  • Carcinoma, Hepatocellular / virology
  • Cohort Studies
  • Comorbidity
  • Cross-Sectional Studies
  • Female
  • Hepatitis B Surface Antigens / blood
  • Hepatitis D, Chronic* / epidemiology
  • Hepatitis Delta Virus* / genetics
  • Hepatitis Delta Virus* / immunology
  • Humans
  • Interferons / therapeutic use
  • Italy / epidemiology
  • Liver Cirrhosis / epidemiology
  • Liver Cirrhosis / virology
  • Liver Neoplasms / epidemiology
  • Liver Neoplasms / virology
  • Male
  • Middle Aged

Substances

  • Hepatitis B Surface Antigens
  • Interferons
  • Antiviral Agents