Hepatitis D virus (HDV) prevalence in Austria is low but causes considerable morbidity due to fast progression to cirrhosis

Mathias Jachs; Teresa Binter; Caroline Schmidbauer; Lukas Hartl; Michael Strasser; Hermann Laferl; Stephanie Hametner-Schreil; Alexander Lindorfer; Kristina Dax; Rudolf E Stauber; Harald H Kessler; Sebastian Bernhofer; Andreas Maieron; Lorin Loacker; Simona Bota; Isabel Santonja; Petra Munda; Mattias Mandorfer; Markus Peck-Radosavljevic; Heidemarie Holzmann; Michael Gschwantler; Heinz Zoller; Peter Ferenci; Thomas Reiberger

doi:10.1002/ueg2.12163

Hepatitis D virus (HDV) prevalence in Austria is low but causes considerable morbidity due to fast progression to cirrhosis

Mathias Jachs
, Teresa Binter
, Caroline Schmidbauer
, Lukas Hartl
, Michael Strasser
, Hermann Laferl
, Stephanie Hametner-Schreil
, Alexander Lindorfer
, Kristina Dax
, Rudolf E Stauber
, Harald H Kessler
, Sebastian Bernhofer
, Andreas Maieron
, Lorin Loacker
, Simona Bota
, Isabel Santonja
, Petra Munda
, Mattias Mandorfer
, Markus Peck-Radosavljevic
, Heidemarie Holzmann

Michael Gschwantler, Heinz Zoller, Peter Ferenci, Thomas Reiberger

Division of Internal Medicine 2 (University Hospital St. Pölten)

Research output: Journal article (peer-reviewed) › Journal article

28 Citations (Scopus)

Abstract

BACKGROUND: Hepatitis D virus (HDV) coinfection aggravates the course of hepatitis B virus (HBV). The prevalence of HDV in Austria is unknown.

OBJECTIVE: This national study aimed at (i) recording the prevalence of HDV-infection in Austria and (ii) characterizing the "active" HDV cohort in Austria.

METHODS: A total of 10 hepatitis treatment centers in Austria participated in this multicenter study and retrospectively collected their HDV patients between Q1/2010 and Q4/2020. Positive anti-HDV and/or HDV-RNA-polymerase chain reaction (PCR) results were retrieved from local database queries. Disease severity was assessed by individual chart review. Viremic HDV patients with clinical visits in/after Q1/2019 were considered as the "active" HDV cohort.

RESULTS: A total of 347 anti-HDV positive patients were identified. In 202 (58.2%) patients, HDV-RNA-PCR test was performed, and 126/202 (62.4%) had confirmed viremia. Hepatocellular carcinoma was diagnosed in 7 (5.6%) patients, 7 (5.6%) patients underwent liver transplantation, and 11 (8.7%) patients died during follow-up. The "active" Austrian HDV cohort included 74 (58.7%) patients: Evidence for advanced chronic liver disease (ACLD, i.e., histological F3/F4 fibrosis, liver stiffness ≥10 kPa, varices, or hepatic venous pressure gradient ≥6 mmHg) was detected in 38 (51.4%) patients, including 2 (5.3%) with decompensation (ascites/hepatic encephalopathy). About 37 (50.0%) patients of the "active" HDV cohort had previously received interferon treatment. Treatment with the sodium-taurocholate cotransporting polypeptide inhibitor bulevirtide was initiated in 20 (27.0%) patients.

CONCLUSION: The number of confirmed HDV viremic cases in Austria is low (<1% of HBV patients) but potentially underestimated. Testing all HBV patients will increase the diagnostic yield. More than half of viremic HDV patients had ACLD. Improved HDV testing and workup strategies will facilitate access to novel antiviral therapies.

Original language	English
Pages (from-to)	1119-1127
Number of pages	9
Journal	United European Gastroenterology Journal
Volume	9
Issue number	10
DOIs	https://doi.org/10.1002/ueg2.12163
Publication status	Published - Dec 2021

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Adult
Austria/epidemiology
Carcinoma, Hepatocellular/epidemiology
Disease Progression
Female
Hepatitis D/diagnosis
Humans
Liver Cirrhosis/epidemiology
Liver Neoplasms/epidemiology
Male
Middle Aged
Prevalence
Retrospective Studies

Access to Document

10.1002/ueg2.12163

Cite this

Jachs, M., Binter, T., Schmidbauer, C., Hartl, L., Strasser, M., Laferl, H., Hametner-Schreil, S., Lindorfer, A., Dax, K., Stauber, R. E., Kessler, H. H., Bernhofer, S., Maieron, A., Loacker, L., Bota, S., Santonja, I., Munda, P., Mandorfer, M., Peck-Radosavljevic, M., ... Reiberger, T. (2021). Hepatitis D virus (HDV) prevalence in Austria is low but causes considerable morbidity due to fast progression to cirrhosis. United European Gastroenterology Journal, 9(10), 1119-1127. https://doi.org/10.1002/ueg2.12163

@article{1ace318c22474fbcacc4f54a24f6dbc5,

title = "Hepatitis D virus (HDV) prevalence in Austria is low but causes considerable morbidity due to fast progression to cirrhosis",

abstract = "BACKGROUND: Hepatitis D virus (HDV) coinfection aggravates the course of hepatitis B virus (HBV). The prevalence of HDV in Austria is unknown.OBJECTIVE: This national study aimed at (i) recording the prevalence of HDV-infection in Austria and (ii) characterizing the {"}active{"} HDV cohort in Austria.METHODS: A total of 10 hepatitis treatment centers in Austria participated in this multicenter study and retrospectively collected their HDV patients between Q1/2010 and Q4/2020. Positive anti-HDV and/or HDV-RNA-polymerase chain reaction (PCR) results were retrieved from local database queries. Disease severity was assessed by individual chart review. Viremic HDV patients with clinical visits in/after Q1/2019 were considered as the {"}active{"} HDV cohort.RESULTS: A total of 347 anti-HDV positive patients were identified. In 202 (58.2\%) patients, HDV-RNA-PCR test was performed, and 126/202 (62.4\%) had confirmed viremia. Hepatocellular carcinoma was diagnosed in 7 (5.6\%) patients, 7 (5.6\%) patients underwent liver transplantation, and 11 (8.7\%) patients died during follow-up. The {"}active{"} Austrian HDV cohort included 74 (58.7\%) patients: Evidence for advanced chronic liver disease (ACLD, i.e., histological F3/F4 fibrosis, liver stiffness ≥10 kPa, varices, or hepatic venous pressure gradient ≥6 mmHg) was detected in 38 (51.4\%) patients, including 2 (5.3\%) with decompensation (ascites/hepatic encephalopathy). About 37 (50.0\%) patients of the {"}active{"} HDV cohort had previously received interferon treatment. Treatment with the sodium-taurocholate cotransporting polypeptide inhibitor bulevirtide was initiated in 20 (27.0\%) patients.CONCLUSION: The number of confirmed HDV viremic cases in Austria is low (<1\% of HBV patients) but potentially underestimated. Testing all HBV patients will increase the diagnostic yield. More than half of viremic HDV patients had ACLD. Improved HDV testing and workup strategies will facilitate access to novel antiviral therapies.",

keywords = "Adult, Austria/epidemiology, Carcinoma, Hepatocellular/epidemiology, Disease Progression, Female, Hepatitis D/diagnosis, Humans, Liver Cirrhosis/epidemiology, Liver Neoplasms/epidemiology, Male, Middle Aged, Prevalence, Retrospective Studies",

author = "Mathias Jachs and Teresa Binter and Caroline Schmidbauer and Lukas Hartl and Michael Strasser and Hermann Laferl and Stephanie Hametner-Schreil and Alexander Lindorfer and Kristina Dax and Stauber, \{Rudolf E\} and Kessler, \{Harald H\} and Sebastian Bernhofer and Andreas Maieron and Lorin Loacker and Simona Bota and Isabel Santonja and Petra Munda and Mattias Mandorfer and Markus Peck-Radosavljevic and Heidemarie Holzmann and Michael Gschwantler and Heinz Zoller and Peter Ferenci and Thomas Reiberger",

note = "Publisher Copyright: {\textcopyright} 2021 The Authors. United European Gastroenterology Journal published by Wiley Periodicals LLC on behalf of United European Gastroenterology.",

year = "2021",

month = dec,

doi = "10.1002/ueg2.12163",

language = "English",

volume = "9",

pages = "1119--1127",

journal = "United European Gastroenterology Journal",

issn = "2050-6406",

publisher = "John Wiley \& Sons Inc.",

number = "10",

}

Jachs, M, Binter, T, Schmidbauer, C, Hartl, L, Strasser, M, Laferl, H, Hametner-Schreil, S, Lindorfer, A, Dax, K, Stauber, RE, Kessler, HH, Bernhofer, S , Maieron, A, Loacker, L, Bota, S, Santonja, I, Munda, P, Mandorfer, M, Peck-Radosavljevic, M, Holzmann, H, Gschwantler, M, Zoller, H, Ferenci, P & Reiberger, T 2021, 'Hepatitis D virus (HDV) prevalence in Austria is low but causes considerable morbidity due to fast progression to cirrhosis', United European Gastroenterology Journal, vol. 9, no. 10, pp. 1119-1127. https://doi.org/10.1002/ueg2.12163

TY - JOUR

T1 - Hepatitis D virus (HDV) prevalence in Austria is low but causes considerable morbidity due to fast progression to cirrhosis

AU - Jachs, Mathias

AU - Binter, Teresa

AU - Schmidbauer, Caroline

AU - Hartl, Lukas

AU - Strasser, Michael

AU - Laferl, Hermann

AU - Hametner-Schreil, Stephanie

AU - Lindorfer, Alexander

AU - Dax, Kristina

AU - Stauber, Rudolf E

AU - Kessler, Harald H

AU - Bernhofer, Sebastian

AU - Maieron, Andreas

AU - Loacker, Lorin

AU - Bota, Simona

AU - Santonja, Isabel

AU - Munda, Petra

AU - Mandorfer, Mattias

AU - Peck-Radosavljevic, Markus

AU - Holzmann, Heidemarie

AU - Gschwantler, Michael

AU - Zoller, Heinz

AU - Ferenci, Peter

AU - Reiberger, Thomas

PY - 2021/12

Y1 - 2021/12

N2 - BACKGROUND: Hepatitis D virus (HDV) coinfection aggravates the course of hepatitis B virus (HBV). The prevalence of HDV in Austria is unknown.OBJECTIVE: This national study aimed at (i) recording the prevalence of HDV-infection in Austria and (ii) characterizing the "active" HDV cohort in Austria.METHODS: A total of 10 hepatitis treatment centers in Austria participated in this multicenter study and retrospectively collected their HDV patients between Q1/2010 and Q4/2020. Positive anti-HDV and/or HDV-RNA-polymerase chain reaction (PCR) results were retrieved from local database queries. Disease severity was assessed by individual chart review. Viremic HDV patients with clinical visits in/after Q1/2019 were considered as the "active" HDV cohort.RESULTS: A total of 347 anti-HDV positive patients were identified. In 202 (58.2%) patients, HDV-RNA-PCR test was performed, and 126/202 (62.4%) had confirmed viremia. Hepatocellular carcinoma was diagnosed in 7 (5.6%) patients, 7 (5.6%) patients underwent liver transplantation, and 11 (8.7%) patients died during follow-up. The "active" Austrian HDV cohort included 74 (58.7%) patients: Evidence for advanced chronic liver disease (ACLD, i.e., histological F3/F4 fibrosis, liver stiffness ≥10 kPa, varices, or hepatic venous pressure gradient ≥6 mmHg) was detected in 38 (51.4%) patients, including 2 (5.3%) with decompensation (ascites/hepatic encephalopathy). About 37 (50.0%) patients of the "active" HDV cohort had previously received interferon treatment. Treatment with the sodium-taurocholate cotransporting polypeptide inhibitor bulevirtide was initiated in 20 (27.0%) patients.CONCLUSION: The number of confirmed HDV viremic cases in Austria is low (<1% of HBV patients) but potentially underestimated. Testing all HBV patients will increase the diagnostic yield. More than half of viremic HDV patients had ACLD. Improved HDV testing and workup strategies will facilitate access to novel antiviral therapies.

AB - BACKGROUND: Hepatitis D virus (HDV) coinfection aggravates the course of hepatitis B virus (HBV). The prevalence of HDV in Austria is unknown.OBJECTIVE: This national study aimed at (i) recording the prevalence of HDV-infection in Austria and (ii) characterizing the "active" HDV cohort in Austria.METHODS: A total of 10 hepatitis treatment centers in Austria participated in this multicenter study and retrospectively collected their HDV patients between Q1/2010 and Q4/2020. Positive anti-HDV and/or HDV-RNA-polymerase chain reaction (PCR) results were retrieved from local database queries. Disease severity was assessed by individual chart review. Viremic HDV patients with clinical visits in/after Q1/2019 were considered as the "active" HDV cohort.RESULTS: A total of 347 anti-HDV positive patients were identified. In 202 (58.2%) patients, HDV-RNA-PCR test was performed, and 126/202 (62.4%) had confirmed viremia. Hepatocellular carcinoma was diagnosed in 7 (5.6%) patients, 7 (5.6%) patients underwent liver transplantation, and 11 (8.7%) patients died during follow-up. The "active" Austrian HDV cohort included 74 (58.7%) patients: Evidence for advanced chronic liver disease (ACLD, i.e., histological F3/F4 fibrosis, liver stiffness ≥10 kPa, varices, or hepatic venous pressure gradient ≥6 mmHg) was detected in 38 (51.4%) patients, including 2 (5.3%) with decompensation (ascites/hepatic encephalopathy). About 37 (50.0%) patients of the "active" HDV cohort had previously received interferon treatment. Treatment with the sodium-taurocholate cotransporting polypeptide inhibitor bulevirtide was initiated in 20 (27.0%) patients.CONCLUSION: The number of confirmed HDV viremic cases in Austria is low (<1% of HBV patients) but potentially underestimated. Testing all HBV patients will increase the diagnostic yield. More than half of viremic HDV patients had ACLD. Improved HDV testing and workup strategies will facilitate access to novel antiviral therapies.

KW - Adult

KW - Austria/epidemiology

KW - Carcinoma, Hepatocellular/epidemiology

KW - Disease Progression

KW - Female

KW - Hepatitis D/diagnosis

KW - Humans

KW - Liver Cirrhosis/epidemiology

KW - Liver Neoplasms/epidemiology

KW - Male

KW - Middle Aged

KW - Prevalence

KW - Retrospective Studies

UR - https://www.scopus.com/pages/publications/85119676469

U2 - 10.1002/ueg2.12163

DO - 10.1002/ueg2.12163

M3 - Journal article

C2 - 34873866

SN - 2050-6406

VL - 9

SP - 1119

EP - 1127

JO - United European Gastroenterology Journal

JF - United European Gastroenterology Journal

IS - 10

ER -

Hepatitis D virus (HDV) prevalence in Austria is low but causes considerable morbidity due to fast progression to cirrhosis

Abstract

UN SDGs

Keywords

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