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HDV risk found to be prevalent in IDUs in Taiwan

Injection drug users in Taiwan, including those with HIV, were found to have an increased risk of hepatitis D virus infection, despite the implementation of a national hepatitis B virus infection vaccination program, according to study data published in Hepatology.

Researchers analyzed data of 2,562 patients (mean age; 46.6 years) with hepatitis B surface antigen (HBsAg) and sought to determine the prevalence, genotype and any risk factors of HDV infection from 2001 to 2012.

“Hepatitis D virus is a defective, single-stranded RNA virus that requires hepatitis B surface antigen envelope for assembly and transmission,” the researchers wrote. “The identification of risk factors causing HDV infections in different populations is crucial for public health measures to control HDV infections.”

Overall, HDV was prevalent in 14.5% of all HBsAg-positive individuals (n = 371). HDV prevalence rates were 74.9% among HIV-infected IDUs; 43.9% among HIV-uninfected IDUs; 11.4% among HIV-infected men who have sex with men; 11.1% among HIV-infected heterosexuals; and 4.4% among the general population of HBsAg-positive individuals.

HDV genotype 4 was the most prevalent genotype among IDUs, whereas HDV genotype 2 was the most prevalent in the non-IDU populations (72.2% vs. 73.3%, respectively). HDV prevalence increased from 38.5% to 89.8% over time in HIV-infected IDUs (OR = 3.06; 95% CI, 1.68-5.56).

Multivariate analysis showed injection drug use, hepatitis C virus, HIV infection, serum HBsAg level of at least 250 IU/mL, duration of drug use, and older age to be associated with HDV infection.

“IDUs, especially HIV-infected IDUs, have become the most important risk group in HDV infection and a reservoir for HDV, even after the implementation of a nationwide HBV vaccination program for 30 years,” the researchers concluded. “Effective strategies, such as methadone maintenance therapy and clean syringe exchange programs, and new policies are needed to prevent injection drug use and educate IDUs on the avoidance of practices that may lead to infection with HDV.” – by Melinda Stevens

Disclosures: The researchers report no relevant financial disclosures.