Abstract：
Hepatitis D virus (HDV) infection occurs as a coinfection with hepatitis B and increases the risk of hepatocellular carcinoma, decompensated cirrhosis, and mortality compared to hepatitis B virus (HBV) monoinfection. Reliable estimates of the prevalence of HDV infection and disease burden are essential to formulate strategies to find coinfected individuals more effectively and efficiently. The global prevalence of HBV infections was estimated to be 262,240,000 in 2021. Only 1,994,000 of the HBV infections were newly diagnosed in 2021, with more than half of the new diagnoses made in China. Our initial estimates indicated a much lower prevalence of HDV antibody (anti-HDV) and HDV RNA positivity than previously reported in published studies. Accurate estimates of HDV prevalence are needed. The most effective method to generate estimates of the prevalence of anti-HDV and HDV RNA positivity and to find undiagnosed individuals at the national level is to implement double reflex testing. This requires anti-HDV testing of all hepatitis B surface antigen-positive individuals and HDV RNA testing of all anti-HDV-positive individuals. This strategy is manageable for healthcare systems since the number of newly diagnosed HBV cases is low. At the global level, a comprehensive HDV screening strategy would require only 1,994,000 HDV antibody tests and less than 89,000 HDV PCR tests. Double reflex testing is the preferred strategy in countries with a low prevalence of HBV and those with a high prevalence of both HBV and HDV. For example, in the European Union and North America only 35,000 and 22,000 cases, respectively, will require anti-HDV testing annually.
摘要：
丁型肝炎病毒（HDV）感染与乙型肝炎合并感染，增加肝细胞癌的风险，失代偿期肝硬化,和死亡率相比，乙型肝炎病毒（HBV）单感染。可靠的HDV感染率和疾病负担估计对于制定策略以更有效和高效地发现合并感染的个体至关重要。HBV+人群的全球患病率估计在2021年为262,240,000。2021年新诊断的HBV感染只有1994,000，其中一半以上在中国。对HDV患病率的初步估计发现，与已发表的研究相比，HDV抗体（抗HDV）和HDVRNA阳性（RNA）病例的患病率要低得多。需要准确估计HDV患病率。开发抗HDV+和HDVRNA+患病率估计并在国家一级发现未诊断个体的最有效方法是实施双反射检测。这需要所有乙型肝炎表面抗原（HBsAg）阳性个体的抗HDV测试和所有抗HDV+个体的HDVRNA测试。由于新诊断的HBV患者的数量很少，因此该策略适用于医疗保健系统。在全球范围内,全面的HDV筛查策略仅需要1,994,000HDV抗体测试和少于89,000HDVPCR测试。双反射测试是在低HBV患病率或高HBV和高HDV患病率设置的首选策略。例如,在欧盟和北美，每年只有35,000和22,000需要进行抗HDV测试。
