Prevalence and epidemiology of hepatitis D among patients with chronic hepatitis B virus infection: a report from Northern Spain

Background The incidence of hepatitis delta virus (HDV) infection has decreased during the last decades. However, an increasing trend has been reported recently. Patients and methods We carried out a case-control study to analyze changes in its prevalence in 1215 chronic hepatitis B virus (HBV) patients, diagnosed consecutively in a tertiary center, between 1983 and 2012. According to the year of diagnosis, patients were distributed into two groups: A [1983-1997 (n=786)] and B [1998-2012 (n = 429)]. Results The prevalence of anti-HDV was 8.2% (9.4% in group A and 6.1% in group B) (P=0.04). Multivariate regression revealed that intravenous drug use [odds ratio (OR) 261.0; 95% confidence interval (CI), 28.7-2368.5; P<0.001], blood transfusion (OR 28.0; 95% CI, 2.7-295.9; P=0.03), anti-HIV(+) (OR 4.8; 95% CI, 1.6-14.5; P=0.004), and high alanine aminotransferase (OR 14.4; 95% CI, 3.4-60.6; P<0.001) were associated independently with the presence of anti-HDV in group A, whereas in group B, it was associated with immigration (OR 20.0; 95% CI, 4.7-84.9; P<0.001), intravenous drug use (OR 683.5; 95% CI, 52.7-8855.7; P < 0.001), promiscuous sexual activity (OR 22.6; 95% CI, 2.2-228.5; P= 0.008), and high alanine aminotransferase (OR 3.4; 95% CI, 1.1-10.0; P=0.02). Conclusion Although a significant decrease in the prevalence of HDV infection has been observed, it is still above 5%. Immigration and sexual transmission have emerged as new risk factors for HDV infection. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.