VIDEO: Without universal screening, ‘tiny’ hepatitis D could ‘wreak havoc’ globally
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In a Healio video exclusive, Edward V. Loftus Jr., MD, warned that, despite being the smallest virus capable of causing human disease, hepatitis delta virus holds an outsized global impact as the most severe form of viral hepatitis.
“This virus requires the presence of hepatitis B to be active, so it’s either a coinfection, or more commonly, a superinfection in patients with hepatitis B,” Loftus, professor of medicine at Mayo Clinic in Rochester and chief medical editor of Healio Gastroenterology, said. “Although this is a tiny virus, it can wreak havoc. The progression to cirrhosis is 80% with hepatitis D and the 10-year survival is approximately 50%, so it’s important to recognize this and treat it accordingly.”
Physicians managing hepatitis D have voiced concerns that surveillance efforts have been hindered by a lack of awareness and inconsistent and inaccurate rates of infection. Faced with a tiny viral target dependent on another virus to replicate, should every patient with HBV be screened for HDV? In this month’s Healio Gastroenterology Exclusive, a roundtable of experts says yes.
“The most important message is that when you see a patient with HBV, whether it be for the first time or as an existing patient in your practice, make sure to screen them for HDV at least once,” Tatyana Kushner, MD, MSCE, wrote in an accompanying editorial. “They may not have the classic risk factors and, especially if you are not aware of all the relevant risk factors, the simple approach is just to screen once. Knowledge of HDV status will influence your treatment approach.”
Loftus echoed the importance of preemptive screening, emphasizing that one of the biggest hurdles these patients face is inconsistency in HDV screening guidelines.
“Screening guidelines across the world are inconsistent, and currently the U.S. guidelines only suggest that high-risk patients be screened – in other words, if you're from a country that is endemic for delta or if you have certain risk factors,” he said.
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