Clinical and virological heterogeneity of hepatitis delta in different regions world-wide: The Hepatitis Delta International Network (HDIN).

Abstract

BACKGROUND & AIMS:

Chronic hepatitis D (delta) is a major global health burden. Clinical and virological characteristics of patients with hepatitis D virus (HDV) infection and treatment approaches in different regions world-wide are poorly defined.

METHODS:

The Hepatitis Delta International Network (HDIN) registry was established in 2011 with centres in Europe, Asia, North- and South America. Here, we report on clinical/ virological characteristics of the first 1576 patients with ongoing or past HDV infection included in the database until October 2016 and performed a retrospective outcome analysis. The primary aim was to investigate if the region of origin was associated with HDV replication and clinical outcome.

RESULTS:

The majority of patients was male (n = 979, 62%) and the mean age was 36.7 years (range 1-79, with 9% of patients younger than 20 years). Most patients were HBeAg-negative (77%) and HDV-RNA positive (85%). Cirrhosis was reported in 48.7% of cases which included 13% of patients with previous or ongoing liver decompensation. Hepatocellular carcinoma (HCC) developed in 30 patients (2.5%) and 44 (3.6%) underwent liver transplantation. Regions of origin were independently associated with clinical endpoints and detectability of HDV RNA. Antiviral therapy was administered to 356 patients with different treatment uptakes in different regions. Of these, 264 patients were treated with interferon-a and 92 were treated with HBV-Nucs only.

CONCLUSIONS:

The HDIN registry confirms the severity of hepatitis delta but also highlights the heterogeneity of patient characteristics and clinical outcomes in different regions. There is an urgent need for novel treatment options for HDV infection.

• Authors: Anika Wranke, Lourdes M Pinheiro Borzacov, Raymundo Parana, Cirley Lobato, Saeed Hamid, Emanoil Ceausu, George N Dalekos, Mario Rizzetto, Adela Turcanu, Grazia A Niro, Farheen Lubna, Minaam Abbas, Patrick Ingiliz, Maria Buti, Peter Ferenci, Thomas Vanwolleghem, Tonya Hayden, Naranjargal Dashdorj, Adriana Motoc, Markus Cornberg, Zaigham Abbas, Cihan Yurdaydin, Michael P Manns, Heiner Wedemeyer, Svenja Hardtke, Hepatitis Delta International Network
• Journal: Liver international : official journal of the International Association for the Study of the Liver (Liver Int) Vol. 38 Issue 5 Pg. 842-850 (05 2018) ISSN: 1478-3231 [Electronic] United States
• PMID: 28963781 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
• Copyright: © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Chemical References

• Antiviral Agents
• Hepatitis B Surface Antigens

Topics

• Adolescent
• Adult
• Aged
• Antiviral Agents (administration & dosage)
• Carcinoma, Hepatocellular (epidemiology, surgery)
• Child
• Child, Preschool
• Cross-Sectional Studies
• Female
• Genetic Heterogeneity
• Hepatitis B Surface Antigens (blood)
• Hepatitis D (complications, drug therapy, epidemiology)
• Hepatitis Delta Virus (genetics)
• Humans
• Infant
• Internationality
• Liver (pathology)
• Liver Cirrhosis (epidemiology)
• Liver Neoplasms (epidemiology, surgery)
• Liver Transplantation
• Logistic Models
• Male
• Middle Aged
• Registries
• Retrospective Studies
• Young Adult