Hepatitis D epidemiology and demographics

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Varun Kumar, M.B.B.S. [2]

Overview

HDV infection affects more than 15 million people chronically infected with HBV worldwide. Regions with high rates of HDV infection include Central Africa, Mediterranean Basin, the Amazon Basin, and parts of Asia. With the implementation of HBV vaccination programs, better education and awareness about the virus, and improving socioeconomic conditions, HDV prevalence is decreasing in many areas of the world.

Epidemiology and Demographics

Prevalence

Worldwide, between 15-20 million people with chronic HBV infection are thought to have HDV co-infection or superinfection. The prevalence ranges from 70% in the Amazon basin to 20% in Africa to <1% in North America. [1]

Developing countries

Areas of high endemicity include Central Africa, the Horn of Africa, the Middle East, eastern and Mediterranean Europe, the Amazon Basin, and parts of Asia. HDV infection rates usually correlate with HBV endemicity except in countries such as Indonesia and Vietnam, where co-infection is uncommon. Prevalence of HDV infection ranges between provinces in China, a country with high a endemicity of HBV. [2] New foci of HDV superinfection continue to be identified in Mongolia, Greenland, Ecuador, and Venezuela.

HDV prevalence is decreasing in many areas of the world including Spain, Turkey, and Taiwan, especially in the last three decades. This has been attributed to vaccination programs for HBV, increased awareness, and an overall improvement in socioeconomic conditions. [2] It should be noted that data for HBV prevalence in developing countries is sparse.

Adapted from Center for Disease Control and Prevention(CDC)[3]

Developed Countries

HDV infection remains prevalent in France whereas in Germany and the UK, the prevalence has increased. In Italy, HDV prevalence was previously decreasing, and has now recently plateaued. These changes in prevalence are mainly attributable to the immigration of persons from regions of high endemicity.[4] HDV prevalence has not been systematically measured for over 10 years in the U.S., but previous reports show a prevalence from 1.4% to 12.1% in chronic HBV carriers depending on the region.

References

  1. Kucirka LM, Farzadegan H, Feld JJ, Mehta SH, Winters M, Glenn JS; et al. (2010). "Prevalence, correlates, and viral dynamics of hepatitis delta among injection drug users". J Infect Dis. 202 (6): 845–52. doi:10.1086/655808. PMC 2924454. PMID 20701536.
  2. 2.0 2.1 Hughes SA, Wedemeyer H, Harrison PM (2011). "Hepatitis delta virus". Lancet. 378 (9785): 73–85. doi:10.1016/S0140-6736(10)61931-9. PMID 21511329.
  3. "Center for Disease Control and Prevention (CDC)".
  4. Wedemeyer H, Manns MP (2010). "Epidemiology, pathogenesis and management of hepatitis D: update and challenges ahead". Nat Rev Gastroenterol Hepatol. 7 (1): 31–40. doi:10.1038/nrgastro.2009.205. PMID 20051970.

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