Prevalence of hepatitis D virus in chronic hepatitis B patients: findings from Poland

PURPOSE: This study aimed to determine the prevalence of hepatitis B/hepatitis D virus (HBV/HDV) co-infections in eastern Poland. MATERIALS/METHODS: We included consecutive patients with chronic hepatitis B treated with nucleos(t)ide analogues (NA) in the study, in whom we performed anti-HDV assays verified by molecular testing. RESULTS: The analysed population consisted of 398 patients, predominantly male with a median age of 50 years, 58.3 ​% of whom had comorbidities. Forty-three patients (10.8 ​%) were diagnosed with cirrhosis. Patients were treated with entecavir, tenofovir, or lamivudine for a median of 5 years. At the start of treatment, the median viral load was 5110 IU/ml, and 98 ​% of patients achieved viral eradication during the therapy. In the study population, anti-HDV antibodies were detected in 6 patients (1.5 ​%), 3 men and 3 women, of whom in 1 (0.25 ​%) the presence of genetic material of the HDV was confirmed by molecular testing. Among anti-HDV-positive patients, 3 (50 ​%) had cirrhosis, 1 of them underwent liver transplantation, and 2 had extrahepatic malignancy. All of them were negative for hepatitis B virus envelope (HBe) antigen and had antibodies to HBe antigen present at the beginning of antiviral treatment. All anti-HDV-positive patients achieved viral clearance during the therapy. CONCLUSION: In a population of almost four hundred patients infected with HBV, we observed a low prevalence of anti-HDV antibodies of 1.5 ​% and HDV replication of only 0.25 ​%. Half of the 6 patients with serologic evidence of co-infection had cirrhosis, so HDV likely played a role in disease progression.